24 year old married obese girl with this classical finding on USG. patient is planning a child. lets discuss management and diagnosis



) PCO refers to the ovaries having a higher number of follicles than normal while PCOS is a metabolic disorder related to heavily unbalanced hormone levels released by a patients ovaries. Unlike PCOS, PCO is not necessarily a disease, as it can just be a deviation from the normal amount of follicles that the average female has (1). You have PCO if you have more than 15 follicles per ovary, while PCOS sufferers generally have 50 or more. PCO is not so much a disease as it is a symptom of an underlying problem. 2) PCO is a more common condition than PCOS While one in ten women have PCOS, having polycystic ovaries is far more common, with anywhere from 20% to 30% of the population having more than the normal amount of follicles in their ovaries (2). Most of those in the latter group will never realize it though, as merely having polycystic ovaries tends to be asymptomatic in many cases (more on this later). 3) PCO develops later in life than PCOS While both PCO and PCOS tending to be genetic, those that merely have polycystic ovaries instead of full-blown polycystic ovarian syndrome usually develop their abnormal amount of follicles late in their 20s (3). Those that have PCOS usually begin showing its symptoms (hirutism, excessive acne, weight problems) during their teen years (4), as the metabolic underpinnings that define it express themselves much earlier than the mere emergence of cysts that are the only signs of PCO. 4) PCO can be caused by a variety of other conditions aside from the machinations behind PCOS Technically, the wacky metabolic problems that cause PCOS are a cause of polycystic ovaries (duh), but it is far from the only reason that women develop PCO. There is a lot of disagreement as to what causes PCO, but alternative explanations outside of the mechanisms behind PCOS point to underactive thyroid glands (hypothyroidism) (5), as well as it being a nascent condition that evolves into PCOS dependent on your eating and exercise habits. 5) Women with PCO can still get pregnant, while those with PCOS have great difficulty with this Women that have been found to have polycystic ovaries can still get pregnant without much difficulty, yet those with PCOS have had problems conceiving (and when they do, the rate of miscarriages is shockingly high). The reason for this is that in the latter case, hormonal balance that many with PCO is possess is completely gone, with insulin stimulating the production of androgens that interferes with proper ovulation (6). Eggs often fail to be released, and when they do make it out of the follicles, they are often at an immature stage of development (7). This results in frequent miscarriages, while women that only have polycystic ovaries dont have compromised hormonal levels, giving them a much better chance of getting pregnant and carrying their fetus through to childbirth.

Very well explained Madam.. Superb

- PCOS - Induction of Ovulation with Letroz 2.5 mg , 10 tablets Start 4 tab on day 2nd 2 tab on 3rd, 4th, 5th day Follicular study , trigar with 5000 iu HCG when leading follicle reach 18 mm size - IUI after 24 hours of HCG

y directly iui sir...can advice normal intercourse ?!

.. Inositol is also used by mouth for treating conditions associated with polycystic ovary syndrome, including failure to ovulate; high blood pressure; high triglycerides; and high levels of testosterone

what is active married life?krimson- 35 for regular period and for lower androgen. can start metformin.weigh reduction most needed.lipid profile and all hormones to be done.if wants early results go for pcod drilling by laparoscopy.

Case of PCOS Treatment-Life style modification 1.Daily 2 hr Exercise 2-Avoid junk Food ,Oily Food 3-Take excess fibre,Vegetables and Water 4-Wt reduction Second line- 1-Metformin 2-Myoinositol 3-Calcium 4-Vit D 5-Wt reducing agent


PCO pattern.... obese...so advice weight loss..life style improvement.... see for FSH:LH ratio...whether anovulation...add CC...

Polycystic ovary, rule out PCOD...do HSG,semen analysis,induuce with letrozole 2.5mg for 5days,add myoinositol

She is a obese lady with PCOD. Do a semen analysis for husband. If it is normal, requires work up of the female. GTT, Ser. Prolactin, FSH, LH &TSH. Put her on strict diet restrictions. After weight reduction, she may go for ovulation. If not induce ovulation. If she is not responding go for diagnostic laparoscopy. Do hydrotubation and ovarian puncture on noth sides. If all parameters are normal, she has high index of conception.

pcod..ask pt to lose 10 percentage of body . avoid food with food with high gllycemic index give her hormones either ocps for 6 months give her ovulation induction with clomophene citrate starting 50mg on day 2 of menstraul cyxle for 5 day with luteal phase support from day 16 with micronised progesterone 200mg for conception

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