Management & Referrals
Primary Care Management
PCOS Management
- • Weight loss (5-10% can restore ovulation)
- • Metformin: Titrate to a target dose of 1500 mg daily in divided doses. Initiate at 500 mg once daily, increase to 500 mg twice daily after two weeks, and subsequently to 500 mg three times daily after an additional two weeks, as tolerated. Consider particularly in patients with BMI > 30.
Hypothyroidism Management
- • Treat if subclinical hypothyroidism (TSH >4.0)
- • Aim for target TSH <2.5
Male Factor Management
- • Lifestyle modifications (as per counselling)
- • Treat reversible causes (infections)
- • Refer to urology if abnormal semen tests and abnormal hormone panel
PEI-Specific Resources
Local Services
- • Sexual Health and Reproductive Services (SHORS): Initial counselling and testing for unaffiliated patients
- • Prince County Hospital OB/GYN: Medical and surgical consultation, ovulation induction, Hysterosalpingogram
- • Queen Elizabeth Hospital OB/GYN: Medical and surgical consultation, ovulation induction, Hysterosalpingogram
Out-of-Province Referrals
For advanced fertility care, patients typically referred to:
- • Atlantic Assisted Reproductive Therapies (Halifax)
- • Conceptia (Moncton)
Follow-up Protocol
- • Every 1-3 months for lifestyle intervention, medication tolerance, continuous education and support
- • Psychological support assessment at each visit
- • Coordinate care with specialists