Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Rashida Begum
Scientific Tracks Abstracts: Pediatr Therapeut
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder aff ecting 4% to 8% of reproductive aged women. About 20% cause of female infertility is anovulation and 85% to 90% of those have PCOS. Th ere is a well established association between PCOS, insulin resistance, hyperinsulinaemia, hyperandrogenism and anovulation. Insulin resistance is a pivotal defect in PCOS and that metabolic abnormality leads to a compensatory increase in circulating insulin and this elevated insulin directly stimulates the ovary to produce excess androgens causing anovulation. As the underlying pathology is being unraveled better management strategies mostly remained symptomatic. For infertility resumption of ovulation by dieting, exercise and ovulation inducing agent remains the cornerstone of treatment. Clomiphene citrate (CC) is the 1st line of treatment resulting 75% to 80% ovulation. Others are called CC resistant who needs insulin sensitizer (Metformin) corticosteroids to combat hyperinsulinaemia and hyperandrogenism. Aromatase inhibitors ( Letrozole) are antioestrogenic agents with much shorter half life is superior in some cases to CC as it has got no negative eff ect on endometrium. In our studies we found satisfactory results by using letrozole, metformin and glucocorticoids. Low dose gonadotropins in step up protocol much eff ective than other ovulation inducing agents but needs meticulous judgment and monitoring. In our study we found better result by using combination of drugs. Laparoscopic ovarian drilling can be restricted for those patients who failed to ovulate by combination of drugs or during assessment of tubal factor. Finally if all eff orts failed to make the patient ovulatory controlled ovarian hyperstimulation and In-vitro fertilization (IVF) is the treatment of choice. Fine tuning is necessary for induction of ovulation in PCOS patients by individualized regimens to get the optimum result.
Prof. Dr. Mosammat Rashida Begum has completed her FCPS in Obstetrics and Gynaecology in 1994, MS in Medical Education from UK in 1999, MSc in Clinical Embryology from UK in 2006 and at terminal stage of PhD in reproductive medicine (PCOS). She has 64 publications in national and international reputed journals. She achieved an international award (Young Scientist Award) for the best research work in 2005 from Asia Ocaenia Federation of Obstetrics and Gynaecology. She contributed chapter in an international book of Nova publisher. She has special interest in infertility and Eclampsia. Now she is working as Professor and Head of the Department of OB/GYN in AKM Medical College, and Chief Consultant of Infertility Care and Research Centre (ICRC) Bangladesh. She attended many national and international conferences and presented number pf papers in national and international conferences.