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1Copyright © 2014 Well Woman Clinic. All rights reserved.
Polycystic Ovaries & Fertility
Log on www.facebook.com/pcosclinic
YouTube: BETTER HEALTH FOR WOMEN: WELL WOMAN CLINIC RADIO
AN ONLINE EDUCATION INITIATIVE OF PCOS CLINIC
• Does PCOS affect fertility & how?
• What are the home remedies I can do to manage PCOS?
• Medical Treatment options – insulin sensitizers, OVI
• Surgical Treatment options – ovarian drilling
• Will I be needing IVF for conception?
Dr Anju Yadav
Dr Nupur
Gupta
Fertility Consultant
Gynecologis
t
9818077238
2Copyright © 2014 Well Woman Clinic. All rights reserved.
The Mother of all Lifestyle
Disorders in Women
Polycystic Ovarian
Syndrome/ PCOS
Dr Nupur Gupta
MBBS, MS, MICOG (Ex AIIMS)
DIRECTOR,
Dept of Obstetrics & Gynecology
Fortis Memorial Research Institute, Gurgaon
3Copyright © 2014 Well Woman Clinic. All rights reserved.
DIFFICULT DIAGNOSIS
 Collection of signs and symptoms
 May be difficult to diagnose
- Heterogeneous presentation
- Features change with age
 No single test or feature is diagnostic of PCOS
4Copyright © 2014 Well Woman Clinic. All rights reserved.
INCIDENCE
 Affects 10 to 20% of females
 20 to 30% have ultrasound appearance
Most common hormonal disorder in
women of reproductive age
5Copyright © 2014 Well Woman Clinic. All rights reserved.
WHAT IS PCOS?
A health problem that can affect a woman’s
 Menstrual cycle,
 Ability to have children
 Hormones
 Heart
 Blood Vessels &
 Appearance
6Copyright © 2014 Well Woman Clinic. All rights reserved.
AGE GROUP
 Adolescent age (pubertal)
 Reproductive age
7Copyright © 2014 Well Woman Clinic. All rights reserved.
Clinical Presentation
8Copyright © 2014 Well Woman Clinic. All rights reserved.
SYMPTOMS
Vary from woman to woman
 Irregular menstrual cycles (amenorrhoea 25%,
oligomenorrhoea 85%, hypomenorrhoea)
 Difficulty in conception 50%
 Weight gain 40%
 Unwanted hair growth
 Acne
9Copyright © 2014 Well Woman Clinic. All rights reserved.
PCOD & INSULIN RESISTANCE
 High insulin levels – high androgens
 Hyperinsulinemia
 Insulin resistance
IR (body cells do not respond
normally to insulin)
10Copyright © 2014 Well Woman Clinic. All rights reserved.
DIAGNOSIS
 CLINICAL
 ULTRASOUND – multiple tiny ovarian cysts (STRING OF
PEARLS)
 BIOCHEMICAL (blood tests) – hormones (LH FSH,
Testosterone, DHEAS, Glucose tolerance test)
 ASSOCIATED TESTS - thyroid, prolactin, lipid profile
11Copyright © 2014 Well Woman Clinic. All rights reserved.
PCOD & WEIGHT GAIN
 Increase in abdominal fat as in males
 Apple figure (waist hip ratio)
 Rise in BMI
12Copyright © 2014 Well Woman Clinic. All rights reserved.
ANOVULATION
Prevents release of eggs from the ovaries
13Copyright © 2014 Well Woman Clinic. All rights reserved.
LIFESTYLE MANAGEMENT: First
Line
 Weight control
 Healthy Diet
 Regular exercise & physical activity
14Copyright © 2014 Well Woman Clinic. All rights reserved.
WEIGHT LOSS & MENSTRUAL CYCLES
If 7% weight loss & 30 to 60
min of moderate physical
activity
 Spontaneous menses
Free androgen
Free insulin
Free testosterone
SHBG
15Copyright © 2014 Well Woman Clinic. All rights reserved.
WEIGHT LOSS & FERTILITY
 In overweight anovulatory women
 Weight loss 6 Kg
 Resumption of ovulation 92%
 Pregnancy rate 65%
 Decrease in insulin & testosterone levels
16Copyright © 2014 Well Woman Clinic. All rights reserved.
MEDICAL TREATMENT
 Metformin - metabolic/glycemic
abnormalities & menstrual irregularities
 Clomiphene, Letrazole, HMG - infertility
 IUI
17Copyright © 2014 Well Woman Clinic. All rights reserved.
SURICAL TREATMENT
 LAPAROSCOPIC OVARIAN DRILLING
 ADHESIOLYSIS
 ENDMETRIOSIS
18Copyright © 2014 Well Woman Clinic. All rights reserved.
HOW TO COPE WITH
EMOTIONAL ASPECTS OF PCOS?
Don’t feel embarrassed
Don’t be depressed
19Copyright © 2014 Well Woman Clinic. All rights reserved.
Early diagnosis & treatment helps prevent long-term
complications, such as infertility, metabolic
syndrome, obesity, diabetes & heart disease
Lifestyle management (weight loss & exercise)
Metformin
IS THERE A CURE FOR PCOS?
CAN IT BE PREVENTED?
20Copyright © 2014 Well Woman Clinic. All rights reserved.
Thanks
NEVER LOSE HOPE
WE ARE THERE
FOR YOU
www.facebook.com/pcosclinic

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Polycystic Ovaries (PCOS) & Fertility

  • 1. 1Copyright © 2014 Well Woman Clinic. All rights reserved. Polycystic Ovaries & Fertility Log on www.facebook.com/pcosclinic YouTube: BETTER HEALTH FOR WOMEN: WELL WOMAN CLINIC RADIO AN ONLINE EDUCATION INITIATIVE OF PCOS CLINIC • Does PCOS affect fertility & how? • What are the home remedies I can do to manage PCOS? • Medical Treatment options – insulin sensitizers, OVI • Surgical Treatment options – ovarian drilling • Will I be needing IVF for conception? Dr Anju Yadav Dr Nupur Gupta Fertility Consultant Gynecologis t 9818077238
  • 2. 2Copyright © 2014 Well Woman Clinic. All rights reserved. The Mother of all Lifestyle Disorders in Women Polycystic Ovarian Syndrome/ PCOS Dr Nupur Gupta MBBS, MS, MICOG (Ex AIIMS) DIRECTOR, Dept of Obstetrics & Gynecology Fortis Memorial Research Institute, Gurgaon
  • 3. 3Copyright © 2014 Well Woman Clinic. All rights reserved. DIFFICULT DIAGNOSIS  Collection of signs and symptoms  May be difficult to diagnose - Heterogeneous presentation - Features change with age  No single test or feature is diagnostic of PCOS
  • 4. 4Copyright © 2014 Well Woman Clinic. All rights reserved. INCIDENCE  Affects 10 to 20% of females  20 to 30% have ultrasound appearance Most common hormonal disorder in women of reproductive age
  • 5. 5Copyright © 2014 Well Woman Clinic. All rights reserved. WHAT IS PCOS? A health problem that can affect a woman’s  Menstrual cycle,  Ability to have children  Hormones  Heart  Blood Vessels &  Appearance
  • 6. 6Copyright © 2014 Well Woman Clinic. All rights reserved. AGE GROUP  Adolescent age (pubertal)  Reproductive age
  • 7. 7Copyright © 2014 Well Woman Clinic. All rights reserved. Clinical Presentation
  • 8. 8Copyright © 2014 Well Woman Clinic. All rights reserved. SYMPTOMS Vary from woman to woman  Irregular menstrual cycles (amenorrhoea 25%, oligomenorrhoea 85%, hypomenorrhoea)  Difficulty in conception 50%  Weight gain 40%  Unwanted hair growth  Acne
  • 9. 9Copyright © 2014 Well Woman Clinic. All rights reserved. PCOD & INSULIN RESISTANCE  High insulin levels – high androgens  Hyperinsulinemia  Insulin resistance IR (body cells do not respond normally to insulin)
  • 10. 10Copyright © 2014 Well Woman Clinic. All rights reserved. DIAGNOSIS  CLINICAL  ULTRASOUND – multiple tiny ovarian cysts (STRING OF PEARLS)  BIOCHEMICAL (blood tests) – hormones (LH FSH, Testosterone, DHEAS, Glucose tolerance test)  ASSOCIATED TESTS - thyroid, prolactin, lipid profile
  • 11. 11Copyright © 2014 Well Woman Clinic. All rights reserved. PCOD & WEIGHT GAIN  Increase in abdominal fat as in males  Apple figure (waist hip ratio)  Rise in BMI
  • 12. 12Copyright © 2014 Well Woman Clinic. All rights reserved. ANOVULATION Prevents release of eggs from the ovaries
  • 13. 13Copyright © 2014 Well Woman Clinic. All rights reserved. LIFESTYLE MANAGEMENT: First Line  Weight control  Healthy Diet  Regular exercise & physical activity
  • 14. 14Copyright © 2014 Well Woman Clinic. All rights reserved. WEIGHT LOSS & MENSTRUAL CYCLES If 7% weight loss & 30 to 60 min of moderate physical activity  Spontaneous menses Free androgen Free insulin Free testosterone SHBG
  • 15. 15Copyright © 2014 Well Woman Clinic. All rights reserved. WEIGHT LOSS & FERTILITY  In overweight anovulatory women  Weight loss 6 Kg  Resumption of ovulation 92%  Pregnancy rate 65%  Decrease in insulin & testosterone levels
  • 16. 16Copyright © 2014 Well Woman Clinic. All rights reserved. MEDICAL TREATMENT  Metformin - metabolic/glycemic abnormalities & menstrual irregularities  Clomiphene, Letrazole, HMG - infertility  IUI
  • 17. 17Copyright © 2014 Well Woman Clinic. All rights reserved. SURICAL TREATMENT  LAPAROSCOPIC OVARIAN DRILLING  ADHESIOLYSIS  ENDMETRIOSIS
  • 18. 18Copyright © 2014 Well Woman Clinic. All rights reserved. HOW TO COPE WITH EMOTIONAL ASPECTS OF PCOS? Don’t feel embarrassed Don’t be depressed
  • 19. 19Copyright © 2014 Well Woman Clinic. All rights reserved. Early diagnosis & treatment helps prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes & heart disease Lifestyle management (weight loss & exercise) Metformin IS THERE A CURE FOR PCOS? CAN IT BE PREVENTED?
  • 20. 20Copyright © 2014 Well Woman Clinic. All rights reserved. Thanks NEVER LOSE HOPE WE ARE THERE FOR YOU www.facebook.com/pcosclinic