Clinical manifestations of polycystic ovary syndrome:
1. Menstrual disorders
This is the most common symptom of PCOS. Women with PCOS may have menstrual cycles ranging from 35 days to 6 months, irregular uterine bleeding, light menstrual flow, or amenorrhea. Although some people have regular menstruation, they do not ovulate, which is called anovulatory menstruation.
2. Infertility
Polycystic ovary syndrome patients of childbearing age suffer from infertility due to low ovulation and no ovulation. Primary infertility (those who have never been pregnant are considered primary infertility) is more common. High androgen affects follicle development, follicle quality, corpus luteum quality, and endometrial receptivity. It will also reduce the chance of pregnancy and increase the rate of spontaneous abortion. At the same time, due to hyperandrogenism and insulin resistance, the risk of pregnancy complications such as gestational diabetes, gestational hypertension, and preeclampsia is also higher than that of healthy people.
3. Hairiness and acne
Caused by high androgens, patients with polycystic ovary syndrome have more obvious body hair on their upper lips, forearms, calves and pubic areas. Greasy skin and acne are also common, which is related to the stimulation of sebaceous gland secretion by high androgens in the body.
4. Obesity
About half of those with polycystic ovary syndrome are also obese.
5. Acanthosis nigricans
It manifests as thickening of the skin in wrinkled areas such as the neck and thighs, with gray-brown pigmentation and soft texture. Related to insulin resistance and a potential marker of diabetes.
Before promoting the ovulation of polycystic cyst, these preparations must be made
01, Reasonable weight loss
Most polycystic patients are obese, so they generally need to lose weight before formal ovulation induction. Weight loss can assist and promote ovulation induction treatment. Some patients lose weight, return to normal menstruation, and even achieve pregnancy.
02Treat other complications
Polycystic disease is heterogeneous and other complications often occur. Such as high blood sugar and high blood insulin, increased androgen, hypothyroidism, etc. In order to ensure the smooth progress of the ovulation induction treatment process, it is best to treat the above conditions before ovulation induction.
03. The man undergoes semen examination
In terms of ovulation promotion conditions, the husband needs to have 2-3 semen tests 2-3 weeks apart to be basically normal, or meet the standards for artificial insemination.
04, Ensure the normal size of the uterus
Some patients have oligomenorrhea and irregular menstruation since puberty. Even only medication can ensure the smooth progress of menstruation. In some patients, some have a small uterus. Before ovulation induction, in order to provide a good growth environment for the fetus, the uterus must be treated accordingly to ensure that the uterus is of normal size.
05Ensure the smooth flow of the fallopian tube
As to whether the fallopian tube is unobstructed, the simple way isUse lipiodol salpingography or ultrasound to confirm whether the fallopian tube is patent. If there is no history of pregnancy and no relevant gynecological surgery, the fallopian tubes are generally unobstructed. However, the specifics need to be judged based on the actual situation.
Pregnancy preparation for polycystic patients:
1. Lifestyle intervention
That is, diet control and exercise therapy, this is the first choice, safest and cheapest treatment method. Especially for people with obesity, weight loss is the basis of all treatments. Losing 5% to 10% of your body weight can help most patients with polycystic ovary syndrome resume ovulation.
Dietary principles: Eat more vegetables, fruits, whole grains, vegetable oils, and fish, supplemented by a small amount of eggs, meat, nuts, etc.
Scientific exercise is an important means of losing weight. It is recommended to choose aerobic exercise, such as jogging, cycling, swimming, etc., and stick to it for a long time. Moderate intensity is the most appropriate exercise intensity. Each exercise session lasts at least 30 minutes, and you should exercise 3 to 5 times a week. Exercise intensity is generally guided by heart rate, which is +20 beats/minute at rest.
2. Adjust menstrual cycle
Natural progestins can be used, such as dydrogesterone, micronized progesterone, etc. In addition, compound short-acting contraceptive pills such as Diane 35 and Yasmin can regulate menstruation while reducing androgen levels in the body.
3. Improve insulin resistance
Metformin is the first choice, which can improve insulin resistance, reduce the patient\’s testosterone level, reduce acne, and restore ovulation.
4. Ovulation induction and pregnancy
If the above treatments are ineffective, it is recommended to perform ovulation induction under the guidance of a specialist.
