A Comprehensive Review of Management of Patients with Infertility having Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects women of reproductive age.It usually starts during adolescence, but symptoms may fluctuate over time.It can lead to hormonal imbalances, irregular periods, excess androgen levels, and cysts in the ovaries.Irregular periods, usually with a lack of ovulation, can make it difficult to become pregnant.Polycystic ovary syndrome is a leading cause of infertility.Various factors, such as lifestyle of an individual, exposure to environmental pollutants, and genetic and epigenetic factors, are responsible for the etiology of PCOS.However, some symptoms can be improved through lifestyle changes, medications, and fertility treatments.Symptoms of PCOS can differ from person to person.The most common symptoms are heavy, long, intermittent, unpredictable, or absent periods, infertility, acne or oily skin, excessive hair on the face or body, male-pattern baldness or hair thinning, and weight gain, especially around the belly.Polycystic ovary syndrome can also cause anxiety, depression, and a negative body image.Some symptoms, such as infertility, obesity, and unwanted hair growth, can lead to social stigma.This can affect other life areas, such as family, relationships, work, and involvement in the community.Blood tests can be used to identify characteristic changes in hormone levels, although these changes are not universal.Women with PCOS may have elevated levels of: Testosterone, estrogen, luteinizing hormone (LH), insulin, and anti-Mllerian hormone (AMH).A combination of pharmacological treatment and lifestyle interventions should be utilized in such patients.Pharmacological therapy includes administration of metformin, clomiphene, letrozole, gonadotrophins [follicle-stimulating hormone (FSH) and LH], and various types of nutraceutical preparations.Surgical treatment (ovarian drilling or bariatric surgery) is an option where the failure of ovulation-inducing agents occurs with multiple cysts present in the ovaries.