By Enda McVeigh, John Guillebaud, Roy Homburg
The Oxford guide of Reproductive drugs and relatives making plans, moment version offers crucial useful details within the care of the adolescent and reproductive age adult females and men. Evidence-based and concise, this guide is the must-have source for all practitioners, trainees, and scholars in sexual and reproductive healthcare. totally up-to-date for the second one version, this instruction manual now contains Read more...
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Sample text
Oral glucose challenge test. 47 48 CHAPTER 5 Polycystic ovary syndrome Prevalence • PCOS is the most common female endocrinopathy, affecting 5–10% of women in their reproductive years. • PCOS is associated with 75% of all anovulatory disorders causing infertility. • Polycystic ovaries can be found in 720% of the female population but are not necessarily associated with the typical symptoms.
Progesterone The main function of progesterone is to stimulate a secretory endometrium containing multiple tortuous glands receptive to a fertilized embryo, allowing it to implant. It also stimulates the expression of genes needed for implantation. As progesterone is produced by luteinized granulosa cells, its concentration only rises to significant amounts following ovulation and declines rapidly with the demise of the corpus luteum before menstruation. Progesterone reaches peak levels in the mid-luteal phase.
Oligo/amenorrhoea. • Infertility. Especially if accompanied by obesity, acanthosis nigricans, or FH of PCOS. Examination and investigation To establish the diagnosis Pelvic ultrasound (transvaginal)—classic picture of PCOS: • 12 or more follicles in at least 1 ovary, measuring 2–9 mm diameter. • Or ovarian volume >10mL. LH, total testosterone, free androgen index not mandatory for diagnosis. To exclude other causes of oligo- and amenorrhoea • Induce withdrawal bleed with progesterone. If no bleed: • FSH—raised in premature ovarian failure, very low in hypogonadotrophic hypogonadism, normal or low normal in PCOS.