27 year old female presented with infertility and amenorrhea. She has undergone a pelvic ultrasound scan. Images are shown below.

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Give her Tab Norethisterone 5 mg bd 5 days. She will have withdrawal bleeding. Start Krimson / Ginette 35.for 3 months. Give Myoinositol( MI) and D chiroinositol ( DCI). If obese start Metformin500 od. After 3 months,do ovulation induction with CC,and follicular study. In the meantime adv LH,FSH,TSH, Investigate the partner also.

Polycystic ovaries with thickened stroma.
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Typical PCOD bilaterally, necklace pattern seen. Do LH ,FSH, S.testosterone, fasting serrum.insulin. S.prolsctin on day 2./3. Correlate with scan. If obese adv wt reduction. Yoga .life style management. Tab krimson 35 OD for 6 months. Myoinositol 2 GM one sachet daily.tab chiocyst added. Myo: ciroinositol in the ratio of 40 : 1. Recheck scan if reduced go for induction. With tab cc and HMG. If PCOD+ go for laprosccopic puncturing of bilateral cysts. At the same r.time Chromotubatio n done for tubal patency and also hysteroscopy at same sitting. Endometrial biopsy for HPE and TBPCR done at same time.

Bilateral polycystic ovaries.Adv thyroid profile,s.prolactin,FSH,LH nd s.testosterone T.Norethisterone 5 mg bd for 5days.Wait for 2 to 15 days.After withdrawal bleeding start induction of ovulation with CC.

Bilat pco. Reason for infertility. Get her hormonal assay and then ovulation induction and follicular imaging.

Typical PCOS.

@A CASE OF PCOS WITH THICKENED STROMA , THE CORTEX & STROMAL RATIO IS VERY MUCH ALTERED.

Polycystic ovaries, wait and watch.

Pcos bilateral practically i have seen metformin having better results than others krimson should b added nd check tft.ask ptl for wt reduction.

I have gone through a case where pt took krimson 35 only for one cycle nd complaind of leg pain doppler lunb showed dvt so b careful age of the pt was 26 .pcos pts alredy have dislipedemia
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Adv FSH LH serum prolactin testosterone HbA1c insulin tests give tab DB 10 TDS for 3 days for withdrawal & then start Krimson35 3 courses. After that go for induction starting on third day of periods

Looks like PCOS. Give her a course of medroxyprogesterone 10 my twice daily for 5days and wait for withdrawal bleeding. After that give her a combination of myoinositol and D chiroinositol for 3 - 6 months. Metformin can also be given for infertility. In the meanwhile investigate for LH FSH ratio, fasting insulin. Life style modification if obese. Ovulation induction can also be done

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