Polycystic ovary syndrome (PCOS) Quiz: Ace Your Exams
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A 25-year-old woman presents to the clinic for a fertility evaluation. She has been trying to conceive with her partner for the past year without success despite regular unprotected intercourse. Her menstrual cycles are irregular, making it harder for her to predict the timing of ovulation. Past medical history is notable for type 2 diabetes mellitus, which is well-controlled with metformin. Her only other medication is a prenatal vitamin. Temperature is 36.5°C (97.8°F), pulse is 72/min, respirations are 18/min, blood pressure is 154/92 mmHg, and body mass index is 36 kg/m2. The physical exam is otherwise unremarkable. A urine pregnancy test done in clinic is negative, and a review of her records shows a recent hemoglobin A1c of 5.8% and blood pressure of 142/88. A bedside pelvic ultrasound shows a normal-sized uterus with a mildly thickened endometrium and no evidence of uterine fibroids; there are 23 antral follicles in the right ovary and 11 in the left. In addition to nutritional counseling and support for healthy weight loss, which of the following is the most appropriate next step in management?
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