Patient presentation
Chief complaint: Irregular periods (cycles 45-90 days) for 5 years. Weight gain + facial hair + acne. Wants to conceive.
History: Married 2 years. TTC for 18 months. BMI 30. Diagnosed PCOS at 22 — was on OCP for 3 years which "fixed" cycles superficially. Stopped OCP last year for conception. USG: bilateral polycystic ovaries (>20 follicles each), endometrial thickness 6mm. TSH normal, prolactin normal, LH/FSH ratio 2.5, testosterone 0.8 ng/ml (elevated for female). Insulin resistance: fasting insulin 22.
Your Assessment (self-test)
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