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  #1  
Old 02-08-2014
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ObGyn In Young Obese

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In a young, obese, chronically anovulatory woman with an elevated LH:FSH ratio which of the following is the preferred method of ovulation induction?
A. metformin
B. human menopausal gonadotropins (hMGs)
C. pulsatile gonadotropin-releasing hormone (GnRH)
D. clomiphene citrate
E. Bromocriptine mesylate
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  #2  
Old 02-08-2014
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Clomiphen citrate
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Old 05-23-2014
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why dont we give metformin, it will let her loose weight and simultaneously induce ovulation
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Old 05-24-2014
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For induction of ovulation for the purpose of conceiving, clomiphene is given because this way you can track ovulation and helps woman get pregnant following it. Metformin not directly causes ovulation. It helps in initiating ovulation and ovulatary cycles in women with PCOS. Because PCOS causes insulin resistance and metformin controls insulin level as well as glucose levels so there is decreased androgens produced by the ovary (hyperinsulinemia is associated with increased androgens and decreased SHBG). So although metformin helps and can be used simultaneously but first line drug for ovulation in order to get pregnant is clomiphene) but for ovulatary cycles and regularity metformin can be used to help.
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Old 05-27-2014
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I'll go with A: Metformin





1st line treatment for PCOS patients who desire pregnancy is Weight Loss. If possible it can restore Ovulation in up to 80% of patients. If weight loss is unsuccessful then metformin can be added. Can take 6months to reach full effect. Metformin is proven to increase ovulation and pregnancy rate (what the question is asking for)

Clomiphene- if the above measures dont work Clomiphene may be attemped. It is firstline if weight is normal (not the case in this question).



source: Epocrates
https://online.epocrates.com/noFrame...veSectionId=41
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Old 05-27-2014
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the goal on PCOS is not a weight loss,but ovulation is..so 1 think that u need to do stimulate ovaries...with CLOMIPHEN.. this is rule of pcos treamemt in worldwide..(ia m OBGYN Dr in my country )
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