Young patient with age 25 years old, nulliparous, married since 4 years complaints of infertility, irregular spotting, irregular menses BMI: 21, No abdominal fat, No Hirsutism Serum B-hCG Negative FSH, LH, TSH, PROLACTIN. All wnl. CBC, urine NAD Semen analysis- Normal, Fasting insulin-15, Blood sugar fasting- 78 USG reveals markedly polycystic ovaries, ovarian volume: 12 cc, 13.5 cc et: 15mm After giving withdrawal, patient had bleeding for 5 days, post menstrual scan revealed, et: 13mm Refractory endometrial hyperplasia is seen.
I started Cyproterone acetate-ethinyloestradiol and Metformin, but she is desirous of fertility. How should I go further.
