EC GYNAECOLOGY Mini Review How do we Manage Obese PCOS Infertile Patients

Poly cystic ovary syndrome (PCOS) is primarily a disorder of clinical and biochemical androgen excess plus either chronic anovulation and/or polycystic ovaries with exclusion of hyperprolactinaemia and 21 hydroxylase deficiency. Over 60% of PCOS patients seen in clinical settings are obese and it becomes challenging to Manage these obese infertile PCOS patients. Importance of life style interventions, role of bariatric surgery when required, various ovulation induction agents with primarily clomiphene citrate and letrozole along with role of anti-obesity drugs and insulin sensitizers like metformin is discussed. Second line treatment include gonadotropins, IVF, electroacupuncture and management according to BMI groups is discussed which needs individualized treatment.