PCOS: diagnosis and management of related infertility

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. It is characterized by a combination of hyperandrogenism (either clinical or biochemical), chronic oligo/anovulation, and polycystic ovaries. It is frequently associated with insulin resistance and obesity. PCOS receives considerable attention because of its high prevalence and possible reproductive, metabolic, and cardiovascular consequences. It is the most common cause of anovulatory infertility.Ovulation induction with clomifene citrate is the first line medical treatment. The aim of ovulation induction is monofollicular growth to avoid multiple pregnancy. The second line treatments include gonadotrophins and laparoscopic ovarian drilling. The role and benefit of metformin in ovulation induction is controversial. Woman with PCOS undergoing IVF are at significant risk of ovarian hyperstimulation syndrome.Women with PCOS are also at an increased risk of developing gestational diabetes, pregnancy induced hypertension, and pre-eclampsia.