I am Dr. Rupali, IVF Specialist, Chikitsa Hospital, Indraprastha Apollo Hospital & Apollo Cradle Royale, Delhi. Today I will talk about the management of PCOS. This management depends on the patient. The first line of management for every patient at every stage of this problem whether it is a minor problem or major problem is lifestyle modification. Now, what does this mean? It means that the patient should be doing certain modification in her own lifestyle that is the way she eats, the way she lives and what are they?
1. The patient should inculcate some practice of exercise. Agar ek patient 1-week mein 150 minutes exercise kar sakta hai, which is of 150 min exercise in the entire week moderate-intensity, then also the condition improves. Agar patient ka weight improve hota hai only 10-15%, most of the symptom will decrease. I have had patients who were 100+ kgs, they became 85 kgs and they conceived self. Agar aap apne khane mein modifications karte hain means aap ko ek hypocaloric diet lena hai jismein carbohydrate content kam ho. And you should have something called smart objective. Really targeted objectives for a lifestyle modification so tha iske results easily achievable hon.
Apart from this, when we talk in terms of infertility, yes, the patient might just need the simple timings of the intercourse along with the ultrasound if required or some drugs. So, these drugs might be some oral drugs or it could be injections. Further, the chances of infertility can be improved by doing IUI or IVF, Laparoscopy perse is not usually required in patients just for PCOS. But yes if something else has been suspected along with PCOS, we tend to do laparoscopy in these patients. More or less if the patient is very keen on getting herself treated with these measures, specifically with the lifestyle modifications, some amount of drugs and there is insulin resistance, we need to give them some amount of metformin. In the end, most of the patients are relieved from the problem and are much happier.