[醫如往常] Senior Clerkship Day 10: Ob/Gyn PCOS

陳教授

Ovary Reserve

1. Age
2. Chemo. MTX不會
3. Original Reserve
4. Genetic

Ovary Function

國外 活產率<5%不建議做IVF
80% Oocyte freezing

20% Embryo Freezing 效果差不多

70% Day3 ET

Ovarian Tissue Freezing before adolescence

Thecal Cell Androgen -> granulosa cell aromatase->estrogen
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PCOS; Polycystic Ovary Syndrome

李醫師R1

黃醫師attending

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Human reproduction

Impact factor 11

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PCOS accounts for 80% infertility

Prevalence 9-18%

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Irregular cycle

>35/<21 days for 2 years

<8 times per year

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>12 follicles of 2-9 mm diameter

Ovary volume>10cc

AMH>35

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Insulin resistance

• BMI>30
• High risk with BMI >25
• DM2 family history

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Tx

Lifestyle modification

Bariatrics surgery

Aromatase inhibitor

Letrozole (自費off label use)

副作用比CC clomiphene少

Metformin

Laparoscopic ovarian Diathermy

(50% response rate)

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張醫師

呂楊醫師報告

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PCOS懷孕要用荷爾蒙調整經期

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Clomiphene

SERM; Selective estrogen receptor modulator

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Folliculometry is a series of Ultrasounds specifically tailored to women trying to get pregnant.

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