If you do not want to conceive, consider talking with your doctor about hormonal birth control. “Combination” birth control pills that contain estrogen and progestin can help you regulate your menstrual cycles, reduce male hormone levels, and help clear up acne. They will also reduce your risk of developing your endometrial cancer. Skin patches and vaginal rings that contain these hormones may also be an option. Your doctor will help you find the option that is right for you. Medications that contain only progesterone offer some of the benefits of combination birth control. They will help control your menstruation and reduce your risk of endometrial cancer. However, they will not help with symptoms related to androgen excess, such as acne and hair growth. Metformin (Glucophage, Fortamet, etc.) is an oral medication for type 2 diabetes. Your doctor may prescribe metformin to treat your insulin resistance and lower your body’s insulin levels. Research has also suggested that metformin may help with cholesterol levels and weight management. People with a history of liver or heart disease may not be able to take metformin safely. It is vital to tell your doctor about your history of any liver or heart conditions. Your doctor may prescribe a medication to help stimulate ovulation. Talk with your doctor about any pre-existing medical conditions or symptoms so that s/he can find the medication that is best for you.  Your doctor may prescribe clomiphene (Clomid, Serophene) or letrozole (Femara). These are oral medications that you take at the first part of your menstrual cycle to stimulate ovulation. You will likely ovulate within 5-10 days after taking clomiphene or letrozole.  You should tell your doctor if you have endometriosis, uterine fibroids, a history of liver disease, or thyroid issues. Side effects of clomiphene or letrozole may include hot flashes, headaches, and breast pain/tenderness.  You should also be aware that in from 7-10 out of 100 pregnancies that result from clomiphene or letrozole therapy, multiple implantations occur. Twins are the most common.  If clomiphene does not work on its own, your doctor may prescribe a combination of metformin and clomiphene. If clomiphene treatment does not work, your doctor may prescribe gonadotropins. Gonadotropins are hormones that stimulate your ovaries to produce multiple follicles (cysts that contain eggs). Injections are usually started on the second or third day of your period and continued for 7 -12 days. These treatments can be expensive, so talk with your reproductive endocrinologist to make sure that they are right for you.  Gonadotropin injections have a relatively high success rate. Of the women who ovulate after gonadotropin therapy and don't have other factors compromising their fertility, up to 50% become pregnant within 4 to 6 ovulatory cycles.  Up to 30% of pregnancies from gonadotropin therapy are associated with multiple implantations. Most multiples are twins, although in 5% of cases it may be triplets or higher. Talk with your doctor about side effects. Most side effects from these injections are mild, but in some cases they may be more serious. A mild form of Ovarian Hyperstimulation Syndrome (OHSS) may occur in 10-30% of gonadotropin patients, and a severe form in about 1% of cases. In the severe cases, OHSS can cause nausea, vomiting, weight gain, blood clotting, and other serious symptoms. In IVF, a fertilized egg is surgically placed into the uterus. It is quite effective. However, IVF can often be expensive and is usually considered as an option when less expensive treatments have not worked. Talk with your doctor about whether you are a good candidate for IVF.  People with PCOS respond strongly to fertility medications, so they are often at higher risk for multiple births. IVF allows for the highest degree of controlling the possibility of multiple births. IVF may cause Ovarian Hyperstimulation Syndrome (OHSS), which can be serious and under extremely rare circumstances can even be fatal. Laparoscopic Ovarian Drilling, or Ovarian Diathermy, is a type of surgical treatment that can help stimulate ovulation in women with PCOS. It is not common and is generally considered a last resort for women for whom other fertility treatments have failed.  Ovarian drilling is done under general anesthesia. A surgeon clinically destroys part of the ovary using a laser or other device. This reduces the amount of testosterone produced by the ovaries, which can increase your possibility of ovulating. A few studies suggest that about 50% of women are able to become pregnant within a year after having this procedure, at least under the best possible circumstances. Ovarian drilling has serious risks, including infection, internal bleeding, injury to internal organs, and scarring. Always talk with your doctor about the risks and side effects before considering this procedure. When taking any medication or treatment, it is important to work closely with your doctor. This is especially important when you are taking reproductive treatments or therapies. Contact your doctor immediately if you experience any side effects from your medication. If you are seeing multiple doctors for your PCOS, such as a primary care physician, gynecologist, and endocrinologist, make sure to keep everyone informed about your health. If you experience any symptoms or side effects from treatment, make sure that your health care providers are aware.
हार्मोनल बर्थ कण्ट्रोल (hormonal birth control) लेने के बारे में विचार करें: डॉक्टर से मेटफोर्मिन (metformin) के बारे में पूछें: फर्टिलिटी की दवाओं के बारे में डॉक्टर से सलाह लें: अपने डॉक्टर से गोनेडोट्रोपिन्स (gonadotropins) के बारे में सलाह लें: इनविट्रो फर्टिलाइजेशन (IVF) के बारे में विचार करें: अपने डॉक्टर से सर्जिकल लेप्रोस्कोपी के बारे में जानें: अपने डॉक्टर से नियमित संवाद बनाये रखें: