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Abstract

A 36-year-old married gravida 0 sees her OB/GYN after stopping oral contraceptive pills (OCPs) in order to get pregnant. She started using OCPs while in college to help with acne. Her weight, since her wedding 5 years ago, has steadily increased by 4–5 pounds per year. While her menstrual cycles on OCPs were regular, every 25 days since OCP discontinuation, her cycles became irregular coming every 6–9 weeks lasting 8 days. Her periods are free of cramps but can be heavy warranting a change in sanitary napkin every hour for the first day. She is otherwise healthy without medical problems and sees her gynecologist on an annual basis. She has never had an abnormal PAP smear and takes no medications other than a daily multivitamin. She is 5′7″ tall and weighs 180 pounds (BMI 28.2 kg/m2). Her physical examination is notable for a blood pressure of 134/88, increased hair growth on her chin and posterior thighs, and she has a skin tag in her left axilla. The following test results are reported in a workup for anovulation: hCG <1.0 mIU/ml; FSH 5.6 mIU/ml; TSH 1.480 mIU/L; FT4 1.21 ng/dL; Prolactin 9.3 ng/mL; 17-OHP 120 ng/dl; DHEAS 240 ug/dl; Total Testosterone 55 ng/dl; HgbA1c 6.0 %; fasting glucose 88 mg/dl; fasting insulin 21 uU/ml; transvaginal ultrasound demonstrates an endometrial lining of 1.2 cm and bilateral ovarian diffuse enlargement with multiple peripheral cysts in a “string of pearls” configuration.

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Correspondence to David Frankfurter M.D. .

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Frankfurter, D. (2015). Getting Pregnant with PCOS. In: Davies, T. (eds) A Case-Based Guide to Clinical Endocrinology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2059-4_38

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  • DOI: https://doi.org/10.1007/978-1-4939-2059-4_38

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