Revolutionizing PCOS Treatment: A Journey Towards Optimal Reproductive Health – ARC Summit

Shifting focus to PCOS management, our clinic employs comprehensive diagnostic measures including TSH, prolactin, and a 2-hour glucose tolerance test to accurately identify insulin resistance, which is often present in 50-70% of our PCOS patients, many of whom are obese. Instead of fasting glucose to insulin ratios, we find the 2-hour glucose tolerance test more effective for detecting insulin resistance.

Addressing weight management, we’ve introduced new medications like monjaro ter apitide, starting with a low dosage of 2.5 milligrams weekly and adjusting based on patient response. Patients often experience significant weight loss, averaging 28 pounds, with some losing up to 58 pounds in three months. These medications not only aid in weight reduction but also treat insulin resistance, providing a dual benefit. Previously, we relied mainly on metformin, which helped with insulin resistance but rarely led to weight loss.

For those struggling with ovulation, we explore several treatment avenues. If medications like Clomid or letrozole fail after three months, we might consider ovarian drilling, but it’s important to discuss potential risks such as diminished ovarian reserve. We avoid using gonadotropins due to the high risk of multiple pregnancies, aligning with our goal to minimize this risk by recommending single embryo transfers.

Our overarching goal is to achieve healthy singleton pregnancies, avoiding twins due to their associated risks like higher rates of gestational complications, preterm delivery, and longer hospital stays even if carried to term. Our approach underscores our commitment to improving health outcomes for our patients, reinforcing our dedication to effective, safe, and well-considered treatment protocols.