Prevalence, presentation and management of polycystic ovary syndrome in Enugu, south east Nigeria.

BACKGROUND

Polycystic ovary syndrome is the most common gynaecological endocrine disorder in women of reproductive age yet, its prevalence and management has not been documented in our area.

OBJECTIVE

To determine the prevalence, presentation and management of polycystic ovary syndrome among women in Enugu, south east Nigerian.

METHOD

A prospective descriptive study of women with polycystic ovaries seen in two major Infertility Clinics in Enugu, South East Nigeria over a 2 year period.

RESULT

A total of 342 women presented with infertility in the centres within the two year period, out of whom 62 had PCOS. PCOS occurred in 18.1% of women in the infertility clinics of the two institutions. The common modes of presentation were: inability to conceive (infertility) in 52 (83.9%), oligomenorrhoea in 45 (72.6%), obesity in 32 (51.6%), LH/FSH ratio > 2 in 28 (45.2%), hyperprolactinaemia in 26 (41.9%) and hirsuitism in 19 (30.6%) women. Ovulation induction was carried out in 42 of the 50 women with anovulatory infertility only. For those 42 women, the mean number of induced cycles was 2.6 = 1.7 (range: 1-6) with 33 (78.6%) of the women being able to do only 3 induced cycles or less. The ovulation induction agents used were clomiphene citrate and human menopausal gonadotrophin either singly or in combination with tamoxifen or bromocryptine. Adjunctive treatments offered consisted of weight reduction in 20 (40.0%) women, metformin in 11 (22.0%) women and dexamethasone in 10 (20.0%) women.

CONCLUSION

PCOS is fairly common occurring in approximately one in six infertile Nigerian women. Infertility, oligomenorrhoea, obesity, LH/FSH ratio > 2, hyperprolactinaemia and hirsutism are the commonest presenting features. On individualized management, about two-fifths of them conceive either spontaneously or following ovulation induction, despite poor compliance to recommended drug regimen.