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Re: anovulationFrom: Shankar Periasamy (shankar@pc.jaring.my)Tue Mar 31 08:15:48 1998
Hi,
>For patients with large ovaries and "necklace sign" or high levels of LH or Mid-follicular phase Sr LH conc - if high, the chance of success reduced and the rate of missed abortion high. (premature LH surge) Diathermy of the ovary increase the response (Adashi, 1995). Concern - ovarian adhesion. Age and D3 FSH & LH good predicting factors in evaluating the response. PCOS respond poorly with CC
>PCOS patients and may well respond to insulin sensitizing agents........ 1.Recently there was an article stating that PCOS were stimulated successfully with hypoglycemic drugs 2.CC 250 mg for 8 days also tried with success 3. Successful induction of ovulation with CC and naltrexone has been reported.
>miscarriage. Missed abortion incidence is high in PCOS. Mostly due to premature LH surge, which causes asynchrony in the nuclear and cytoplasmic maturation resulting in compromised oocytes. IGF-beta (insulin-like growth factor) plays an important role in the pathophysiology. A very good review article on pathophysiology of PCOS by monash group - worth reading Shankar
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