At present, there are three methods to treat polycystic ovary: 1 and hormone therapy. The commonly used hormones are Diane -35, Mafuron, clomiphene citrate and metformin. 2. Chinese medicine treatment: Chinese medicine treatment also focuses on regulating menstruation and promoting ovulation. 3. Surgical treatment: 1/3 wedge-shaped ovariectomy. Among them, drug therapy: 1. Obesity and insulin resistance increase exercise to lose weight, correct endocrine and metabolic disorders aggravated by obesity, reduce insulin resistance and hyperinsulinemia, reduce IGF- 1, increase IGfBP- 1 and increase SHBG, which will reduce the level of free androgen. Losing weight can restore ovulation in some obese PCOS patients and prevent type 2 diabetes and cardiovascular diseases. Metformin 1.5 ~ 2.5g/d, with or without diabetes, can effectively lose weight, improve insulin sensitivity, reduce insulin level, reduce hair, and even restore menstruation (25%) and ovulation. Because obesity and insulin resistance are the main causes of PCOS, all drugs that can reduce weight and increase insulin sensitivity can treat this syndrome. In recent years, there have been many reports about the treatment of insulin sensitizers. Thiazolidinone is an oral insulin sensitizer, which is mainly used to treat diabetes. For example, troglitazone can significantly reduce hyperinsulinemia and hyperandrogenism in PCOS patients, and help to induce ovulation. Ciotta et al reported that insulin sensitizer can significantly reduce serum LH and androgen levels, inhibit insulin secretion and increase SHBG concentration, which can be treated for a long time. Insulin sensitizer may be more suitable for PCOS patients with hyperinsulinemia. 2. Clomiphene citrate is the first choice for drug-induced ovulation (1)PCOS, with ovulation rate of 60% ~ 80% and pregnancy rate of 30% ~ 50%. Clomiphene competes with endogenous estrogen for receptor at hypothalamus-pituitary level, which inhibits estrogen negative feedback and increases the pulse frequency of GnRH secretion, thus regulating the secretion ratio of LH and FSH. Clomiphene citrate also directly promotes ovarian synthesis and secretion of estrogen. From the 5th day of the natural menstrual cycle or uterine bleeding due to drug withdrawal, 50mg is taken orally every day, 5 times in a row for 1 course of treatment. Ovulation usually occurs on 3 ~ 10 days (average 7 days) after taking the medicine, and most of them get pregnant within 3 ~ 4 courses of treatment. If there is still no ovulation after three treatment cycles, the dose can be increased to 100 ~ 150 mg per day, and the initial dose (25mg/d) can be reduced for those with lighter weight. After taking this medicine, the ovaries were enlarged (13.6%) due to excessive stimulation, and the blood vessels were dilated, resulting in sudden heat sensation (10.4%), abdominal discomfort (5.5%), blurred vision (10.5%), rash, slight alopecia and other side effects. During the treatment, it is necessary to record the basal body temperature of menstrual cycle, monitor ovulation, or determine serum progesterone and estradiol to confirm ovulation and guide the dose adjustment of the next course of treatment. If there is still no ovulation or pregnancy after clomiphene citrate treatment for 6 ~ 12 months, clomiphene citrate plus HCG or glucocorticoid, bromocriptine or HMG, FSH and GnRH can be given. (2) Clomiphene citrate combined with chorionic gonadotropin (HCG): On the 7th day after stopping clomiphene citrate, 2000 ~ 5000 U of HCG was added for intramuscular injection. (3) Combination of glucocorticoid and clomiphene citrate: The effect of adrenocortical hormone is based on its inhibition of excessive androgen secretion in ovary or adrenal gland. Dexamethasone or prednisone is usually used. The daily dose of prednisone is 7.5 ~ 10 mg, and the effective rate is 35.7% within 2 months. The ovarian function of patients with amenorrhea and anovulation recovered to some extent. When the induction of ovulation by clomiphene citrate is ineffective, dexamethasone 0.5mg, 2.0mg every night, for *** 10 days can be taken at the same time during the treatment cycle, so as to improve the response of clomiphene citrate or pituitary gland to gonadotropin therapy and increase the ovulation rate and pregnancy rate. (4) Uridine (HMG): It is mainly used for patients with decreased endogenous pituitary gonadotropin and estrogen secretion. Uridine (HMG) is a purified extract extracted from the urine of menopausal women, which contains FSH and LH in the ratio of 1: 1, and each ampoule contains 75U FSH and LH. Urinary gonadotropin (HMG) is considered as an alternative drug to induce ovulation in the treatment of anovulatory infertility. Because of its many side effects, it is more dangerous to induce ovarian hyperstimulation syndrome (OHSS). Generally, intramuscular injection of HMG 1 ampoule is started every day. After 3 ~ 4 days, if the serum estradiol level gradually increases, continue to use the drug. If the level of estradiol does not increase, 0.5 ~ 1 ampoule can be added. The dosage will be adjusted according to the situation after 3 days. When the urinary estrogen level reaches 50 ~ 100? G/24h, or when the serum estradiol is 500 ~ 1000 pg/ml, or the ovarian enlargement is obvious, the drug should be stopped. The therapeutic dose of human chorionic gonadotropin (HCG) should vary with people and treatment cycle, and strict monitoring measures should be taken to prevent ovarian hyperstimulation syndrome (OHSS). (5) Gonadotropin-releasing hormone (GnRH): GnRH can promote the release of FSH and LH from pituitary, but long-term application makes GnRH receptors in pituitary cells insensitive, which leads to the decrease of gonadotropin, thus reducing the synthesis of ovarian sex hormones. Its effect is reversible, and it begins to excite FSH, LH in pituitary and sex hormones in ovary. /kloc-decreased to normal level after 0/4 days and reached castration level after 28 days. Can GnRH-A 150 be used clinically? G, subcutaneous injection 1 time every day, from the follicular phase, or from the luteal phase of the last 1 cycle (2nd1day). After the sex hormones reached the castration level, ovulation was induced with the same dose of HCG as before. This can avoid premature LH peak in menstrual cycle, leading to luteinization of follicles. However, the clinical application of GnRH-A is limited because of its high value and large dosage. (6) FSH: FSH includes purified and recombinant human FSH (RH FSH). FSH is an ideal therapeutic agent for polycystic ovary, but it is expensive. And it may cause OHSS. During the medication, the changes of ovary must be closely monitored. The dosage of 75U is relatively safe. FSH can also be combined with GnRH-A to improve the success rate of ovulation. (7) Bromocriptine: It is suitable for ICOS patients with high PRL. The initial dose is 1.25mg, twice a day, and can be gradually increased to 2.5mg, twice or three times a day, after meals. 3. Wedge resection of bilateral ovaries is suitable for patients with elevated blood testosterone, bilateral ovarian enlargement and normal DHEA and PRL (suggesting that the main cause is ovaries). Excision of part of the ovary and excessive androgen secretion can correct the adjustment disorder of hypothalamus-pituitary-ovary axis, but the location and amount of the excised tissue are related to the curative effect, and the effective rate varies. The pregnancy rate is 50% ~ 60%. Postoperative recurrence rate is high, and if pelvic adhesion is complicated, it is not conducive to pregnancy. Laparoscopic ovarian cautery or resection can also achieve certain results. 4. the treatment of hirsutism can be cut off or coated with "hair loss agent" regularly, and it can't be pulled out to prevent hair follicles from overgrowth. It can also be used for electric erosion treatment or androgen inhibition drugs. (1) Oral contraceptives: Estrogen and Progesterone Compound Tablets are ideal, which can inhibit LH secretion, reduce blood testosterone, androstenedione and DHEAS, and increase the concentration of sex hormone binding globulin. (2) Progesterone: It has weak antiandrogen and slightly inhibited gonadotropin secretion, and can reduce the levels of testosterone and 17- ketosteroid. Medroxyprogesterone acetate (medroxyprogesterone acetate) is commonly used. Generally, 6 ~ 8 mg/d is taken orally. In addition, cyproterone acetate (cyproterone acetate; CPA) is an efficient progesterone with strong antiandrogen effect. Often taken with ethinyl estradiol. (3)GnRH-A: started to be used on day 1 ~ 5 of menstrual cycle, and there are various preparations such as percutaneous inhalation, subcutaneous injection and intramuscular injection. Taking ethinyl estradiol at the same time can avoid the adverse reactions caused by estrogen after taking it. (4) Dexamethasone: 0.25 ~ 0.5 mg/d is suitable for adrenal androgen excess. Take orally every night. (5) Spironolactone: It can interfere with the synthesis of ovarian androgen by preventing testosterone from binding to hair follicle receptor or by inhibiting 17α- amylase. Take 50 mg orally every day. It can reduce the hair growth of patients and make the hair thinner. Patients with hyperandrogenism and anovulation with menstrual disorder can take 20mg orally every day from the fifth day to the second day1day, which can make some patients resume menstrual cycle and ovulation. 5. Artificial cycle For patients without hirsutism and fertility requirements, progesterone can be given artificial cycle treatment to avoid endometrial hyperplasia and canceration.