Metformin is a drug that can be useful in the formation of insulin. Metformin is safe for women who do not have diabetes, because this affects insulin production, without lowering blood sugar levels. This drug increases the sensitivity of the body to insulin - it helps the body use insulin better, thereby controlling blood sugar levels.
High levels of insulin provoke an increase in the concentration of male hormones. As a rule, metformin provides a decrease in the level of male hormones, which sometimes becomes sufficient to resume normal ovulation.
Clomid (or Clomiphene Citrate) is the most commonly used drug for stimulating ovulation in PCOS in women with infertility. Clomiphene regulates the normal production of FSH and LH, thereby providing ovulation. Clomid quite often provides ovulation in women with polycystic ovary syndrome, but pregnancy occurs only in 30-40% of these women.
In most cases, clomid is given in the first days of the cycle (2-7) and results in ovulation in about 80% of women in general. Treatment with clomid is successful quite often - within six months of treatment with clomid, pregnancy occurs in 45% -50%. One of the side effects of clomid treatment is a multiple pregnancy.
If clomid is not effective, injections of gonadotropins should be used that work directly to stimulate the production of follicles and ovulation. Treatment with gonadotropins is carried out in parallel with dynamic monitoring. Multiple pregnancy in this treatment is often observed - this is due to the fact that the polycystic ovaries are particularly sensitive to hormones.
There is also a surgical method for treating polycystic ovaries - laparoscopic ovarian diathermy. This can lead to a decrease in the level of androgens and the restoration of ovulation, and can also make the ovaries more sensitive to clomid. The highest frequency of pregnancy was noted during the first year after surgery (about 60-80%).
A less common method of treatment is wedge resection of the ovaries.
In Vitro Fertilization (IVF) is another option for the treatment of infertility in PCOS.