1.9 INFERTILITY AND PCOS EXAM
QUESTIONS WITH CORRECT ANSWERS
Treatment goals of PCOS - ANSWER-1- lessen symptoms of hyperandrogenism
2-manage metabolic abnormalities
3-Prevent chronic anovulation which can lead to endometrial hyperplasia and
Carcinoma
4-Contraception or ovulation induction if desired fertility
First line meds for PCOS - ANSWER-Oral contraceptive pills
What do Oral contraceptives do for PCOS patients - ANSWER-1- protects against
endometrial hyperplasia
2-contraception
3-helps w/ acne, hirsuitism
What type of oral contraceptive should you choose for your PCOS patient - ANSWER-
One with minimal androgenicity like those that contain norgestimate, desogestrel and
drospirenon
* ex: Ortho-tricyclen, desogen, BeYaz
Second line for your PCOS patient... perhaps if they don't want an oral contraceptive -
ANSWER-Spironolactone
* aldosterone and androgen antagonist....
Meformin and PCOS - ANSWER-1- decreases serum free testosterone
2-Increases HDL
3-Wt loss
4- restores ovulation in 50% of PCOS patients
--> but no longer first line!! or additive either.... except in diabetics or glucose intolerance
If you have an infertile patient and you give them the provera challenge test and no
withdrawal bleed - ANSWER-if no spontaneous ovulation.... start on day 3-5:
1- clomiphene citrate ( anti-estrogen)
OR
2- Letrozole ( aromatase inhibitor)
Check serum progesterone on day 21
If you check progesterone ( serum) on day 12 and you get ovulation.... - ANSWER-no
dose change
QUESTIONS WITH CORRECT ANSWERS
Treatment goals of PCOS - ANSWER-1- lessen symptoms of hyperandrogenism
2-manage metabolic abnormalities
3-Prevent chronic anovulation which can lead to endometrial hyperplasia and
Carcinoma
4-Contraception or ovulation induction if desired fertility
First line meds for PCOS - ANSWER-Oral contraceptive pills
What do Oral contraceptives do for PCOS patients - ANSWER-1- protects against
endometrial hyperplasia
2-contraception
3-helps w/ acne, hirsuitism
What type of oral contraceptive should you choose for your PCOS patient - ANSWER-
One with minimal androgenicity like those that contain norgestimate, desogestrel and
drospirenon
* ex: Ortho-tricyclen, desogen, BeYaz
Second line for your PCOS patient... perhaps if they don't want an oral contraceptive -
ANSWER-Spironolactone
* aldosterone and androgen antagonist....
Meformin and PCOS - ANSWER-1- decreases serum free testosterone
2-Increases HDL
3-Wt loss
4- restores ovulation in 50% of PCOS patients
--> but no longer first line!! or additive either.... except in diabetics or glucose intolerance
If you have an infertile patient and you give them the provera challenge test and no
withdrawal bleed - ANSWER-if no spontaneous ovulation.... start on day 3-5:
1- clomiphene citrate ( anti-estrogen)
OR
2- Letrozole ( aromatase inhibitor)
Check serum progesterone on day 21
If you check progesterone ( serum) on day 12 and you get ovulation.... - ANSWER-no
dose change
