A pelvic ultrasound (transvaginal and/or pelvic/abdominal) is used to evaluate enlarged ovaries. Ultrasounds are often used to look for cysts in the ovaries and to see if the internal structures appear normal. In PCOS, the ovaries may be 1.5 to 3 times larger than normal and characteristically have more than 12 or more follicles per ovary measuring 2 to 9 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." The follicles tend to be small and immature, thus never reaching full development. The ultrasound helps visualize these changes in more than 90% of women with PCOS, but they are also found in up to 25% of women without PCOS symptoms. (For more, see RadiologyInfo.org: Pelvic ultrasound.)
Medications for PCOS include oral contraceptives and metformin. The oral contraceptives increase sex hormone binding globulin production, which increases binding of free testosterone. This reduces the symptoms of hirsutism caused by high testosterone and regulates return to normal menstrual periods. Metformin is a medication commonly used in type 2 diabetes mellitus to reduce insulin resistance, and is used off label (in the UK, US, AU and EU) to treat insulin resistance seen in PCOS. In many cases, metformin also supports ovarian function and return to normal ovulation.[74][78] Spironolactone can be used for its antiandrogenic effects, and the topical cream eflornithine can be used to reduce facial hair. A newer insulin resistance medication class, the thiazolidinediones (glitazones), have shown equivalent efficacy to metformin, but metformin has a more favorable side effect profile.[79][80] The United Kingdom's National Institute for Health and Clinical Excellence recommended in 2004 that women with PCOS and a body mass index above 25 be given metformin when other therapy has failed to produce results.[81][82] Metformin may not be effective in every type of PCOS, and therefore there is some disagreement about whether it should be used as a general first line therapy.[83] The use of statins in the management of underlying metabolic syndrome remains unclear.[84]
Dandelion Root (Taraxacum officinale): This herb is an effective liver detoxifier and bile flow stimulant. It is used to cleanse the liver and get rid of any build-up of hormones. This clean up can stimulate the production of SHGB which also means free testosterone in the blood is decreased.7 Dandelion root is used for PCOS treatment because menstrual irregularities are often affected by the liver being backed up with excessive hormones.
Hola, hace unos 6 años me detectaron SOP, me mandaron la píldora ya que no habia otro tipo de tratamiento, me lo diagnosticaron por mi falta de regla y exceso de bello. Hace como unos 6 meses deje la píldora para ver como reaccionaba mi cuerpo, no reacciono bien, volvi a las reglas irregulares y ahora llevo 3 meses sin que me baje. vi vuestra pag de casualidad, y quisiera saber si tomando vuestras pastillas se regulara de forma natural la regla y si hay posiblidad de que baje.
i'm guessing Luna knows two different Pats. one Pat is Patricia Allen, the one who is rlyblonde' mom who has also been buying her groceries and shit. and the other Pat is the woman with cancer. but i don't know. i just don't think rlyblonde's mom is the same pat as the cancer pat, i haven't seen anything that would insinuate Patricia Allen once had cancer or worked with Luna
PCOS treatment is different for different people. While there is no cure for PCOS, taking medicine and losing weight can help  your symptoms. If you don’t want to become pregnant, your doctor or nurse may recommend hormonal birth control, like the hormonal IUD, birth control implant, pill, patch, ring, or shot to treat your PCOS. The pill, patch, or ring may be particularly helpful if you’re struggling with acne or want more regular periods. If you’re trying to get pregnant, drugs that treat insulin resistance may help, as well as certain fertility drugs that can help you ovulate. Losing weight can also help with ovulation and fertility.
Patients with polycystic ovarian syndrome (PCOS) who have impaired glucose tolerance should start a comprehensive program of diet and exercise to reduce their risk of developing diabetes mellitus. Encourage moderate physical activity, provided the patient has no contraindications. Discourage smoking because of the increased risk of cardiovascular disease. In addition, obese women with PCOS can benefit from a low-calorie diet for weight reduction.

Another study, a double-blind trial by Legro et al, found that letrozole is more effective than clomiphene in the treatment of infertility in PCOS. Based on treatment periods of up to five cycles, the study, which involved 750 anovulatory women with PCOS, found that the birth rates for letrozole and clomiphene were 27.5% and 19.1%, respectively. The rate of congenital abnormalities and the risk of pregnancy loss in the letrozole and clomiphene groups were found to be comparable, although the likelihood of twin births was lower with letrozole. [53, 54]
Es posible que el médico pida análisis de sangre de niveles hormonales, colesterol o glucosa (azúcar) en la sangre. A veces, los médicos hacen un examen pélvico o piden exámenes de ultrasonido (con imágenes) de los ovarios y el útero. Este tipo de prueba puede mostrar si usted tiene quistes ováricos, que son burbujas llenas de líquido dentro o fuera de los ovarios. Su médico se asegurará de que no existan otras causas de períodos irregulares o alteraciones en el nivel hormonal.

There's also a good and bad way to go about nitpicking, imo. For every person laughing at Momo's dimpled ass, there are ten anons going 'ewwwwww look at _____'s potato nose i'd kms if i had it' or 'omg she needs surgery on her chin' and other ridiculous overreactions to normal photos/facial features that seem like they're made by young teens who want to make themselves feel more attractive.
For women who don’t receive timely, appropriate care for PCOS in early adolescence, the development of symptoms such as facial-hair growth can become more challenging to treat. Brandy Cramer, 33, a program officer at The Cameron Foundation, from Midlothian, Virginia says her doctors told her she just wasn’t trying hard enough to lose weight and dismissed her when she requested they run blood tests or suggest alternatives to the birth-control pills that gave her intense migraines. Cramer grew facial hair and has only been able to remove 50 percent of it, even after expensive laser hair-removal treatment.
It’s important to follow-up regularly with your health care provider and make sure you take all the medications prescribed to regulate your periods and lessen your chance of getting diabetes or other health problems. Because you have a slightly higher chance of developing diabetes, your health care provider may suggest that you have your blood sugar tested once a year, or have a glucose challenge test every few years. Quitting smoking (or never starting) will also improve your overall health. Because you have a higher chance of developing diabetes, your health care provider may suggest having a:

Not all women with PCOS have difficulty becoming pregnant. For those that do, anovulation or infrequent ovulation is a common cause. Other factors include changed levels of gonadotropins, hyperandrogenemia and hyperinsulinemia.[89] Like women without PCOS, women with PCOS that are ovulating may be infertile due to other causes, such as tubal blockages due to a history of sexually transmitted diseases.
Sylvia Rebecca - "I have to share how good I feel since joining this program. I have been on it for 3 weeks. I take the supplements faithfully, started working out, eat better and drink half my body weight in water. My mood swings are better and I just feel happier. For the last 3 years I have been depressed and did not want to do anything, but look at me now. I am hoping that my period will start soon. This is the next step for me. I do not get a period without taking Provera. You guys are also an amazing group of women and so happy to be on this journey with all of you. A NEW ME!!!!!!"
I smoke indoors and as long as you keep the window open and vacuum slightly more often there's no noticeable grime. You should clean your walls with cold water once a year or so to stop build-up of random crap regardless of whether you smoke. Tuna's grime has built up over years of neglect, smoking probably hasn't helped but it's mainly because she's nasty.

For those women that after weight loss still are anovulatory or for anovulatory lean women, then the ovulation-inducing medications clomiphene citrate[74] and FSH are the principal treatments used to promote ovulation.[medical citation needed] Previously, the anti-diabetes medication metformin was recommended treatment for anovulation, but it appears less effective than clomiphene.[medical citation needed][90]
Preclinical and clinical studies provide preliminary evidence that six herbal medicines may have beneficial effects for women with oligo/amenorrhea, hyperandrogenism and PCOS. The quality of the evidence is variable and strongest for Vitex agnus-castus and Cimicifuga racemosa in the management of oligo/amenorrhea and infertility associated with PCOS; and Cinnamomum cassia for improving metabolic hormones in PCOS. Evidence for Tribulus terrestris, Glycyrrhiza spp. alone and in combination with Paeonia lactiflora and Paeonia lactiflora combined with Cinnamon cassia is promising but in an emergent phase. Further investigations into the mechanisms of effect for herbal extracts are needed to complete our understanding of the reproductive endocrinological effects for herbal medicine for these common conditions.
just saying, sometimes on payday i head to the drugstore and buy one or two nyx lip products along with other stuff and they're just under 10 euro a pop here. Like on payday I feel pretty dodgy for paying 30 euro for like three lip products. I imagine even her dad would feel weird about spending that much money on something so stupid when he could get her groceries or actual useful bathing products instead.
“When any condition crosses disciplines and doesn’t have a full investment in [one of them], it often falls through the cracks. There are elements of reproduction in PCOS, but most reproductive endocrinologists mostly do in-vitro fertilization and are not necessarily interested in metabolism. Medical endocrinologists, who are mostly interested in metabolism, aren’t usually interested in reproduction and ovarian function,” Dumesic said.
Gayunpaman, kinakailangan pang magsagawa ng karagdagang pag-aaral  upang mapagtibay  ang claim na ito, ang bagong tuklas na pag-aaral na ito ay maaaring maging sanhi ng mga pagbabago sa kung paano haharapin ng mga medical practitioners ang kondisyong ito, na kung saan naaapektuhan ang isa sa 10 mga kababaihan sa buong mundo, ayon sa National Institutes of Health.
If you’re overweight, many of symptoms will improve if you can lose just a little. Dropping just 5 to 10% of your body weight (9 to 18 pounds if you now weigh 180) can make your body more sensitive to insulin (reducing the insulin resistance behind PCOS), lead to more regular menstrual cycles, and could even help control severe acne and excess hair growth,1 according to the American College of Obstetricians and Gynecologists (ACOG).
Royal jelly ay ang pagkain na ay fed sa queen bee sa isang bahay-pukyutan. Ito ay naglalaman ng isang rich konsentrasyon ng nutrients, bitamina, at mineral na makakatulong sa abeha-reyna upang maging malusog at magagawang upang maglatag ng higit sa 2000 mga itlog sa bawat araw. Sinasabing upang suportahan ang ovarian function. Mga eksperimento ay pinapakita na hari o reyna halaya exerts estrogen epekto at tumutulong upang pangalagaan ang mga abnormalidad sa panregla cycle. Ang paggamit ng mga herbal supplement ay maaaring makatulong sa iyong mga ovaries sa paggampan ng kanilang mga pag-andar makita nang husto (12).
Moran, L. J., Ko, H., Misso, M., Marsh, K., Noakes, M., Talbot, M., … Teede, H. J. (2013, April). Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines [Abstract]. Journal of the Academy of Nutrition and Dietetics, 113(4), 520–545. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23420000

Metformin is among one of the main treatments to target insulin resistance if you have prediabetes or diabetes, including because of PCOS. The advice is controversial, but some physicians believe that PCOS always requires metformin, notes Dr. Dunaif. “There’s no reason to give every woman with PCOS metformin. It’s a good and safe drug, but there’s no point in taking it if you don’t need it,” she says. (She notes that it has such a good safety profile that even when overprescribed, it doesn’t cause any harm.) But it’s not a good way to reduce the male hormone symptoms, like excess hair growth.


“If a woman has fewer than eight menstrual periods a year on a chronic basis, she probably has a 50 to 80 percent chance of having polycystic ovary syndrome based on that single observation,” said John Nestler, the chair of the department of internal medicine at Virginia Commonwealth University. “But if she has infrequent menstruation and she has elevated levels of androgens such as testosterone in the blood, than she has a greater than 90 percent chance of having the condition.”
Polycystic ovary syndrome (PCOS) can be a daunting diagnosis to receive. The National Polycystic Ovary Syndrome Association defines the condition as a “genetic, hormonal, metabolic, and reproductive disorder that affects women.” (1) One in 10 women have it (about half don’t know it), and the complications can include infertility, obesity, and mood disorders.

Diagnosis can generally be accomplished with a careful history, physical examination, and basic laboratory testing, without the need for ultrasonography or other imaging. Hyperandrogenism can be diagnosed clinically by the presence of excessive acne, androgenic alopecia, or hirsutism (terminal hair in a male-pattern distribution); or chemically, by elevated serum levels of total, bioavailable, or free testosterone or dehydroepiandrosterone sulfate.23 Measurement of androgen levels is helpful in the rare occasion that an androgen-secreting tumor is suspected (e.g., when a patient has marked virilization or rapid onset of symptoms associated with PCOS).
Results of a second study by the same research team offer doctors a clear strategy to help you lose weight.5 According to this study at Penn State Health in Philadelphia, patients who worked with their physician to follow a limited fat, low calorie diet (~1200 calories) by relying on low-calorie prepared meals (eg, SmartOnes, Lean Cuisine or Healthy Choice) and an appetite suppressant with meals and making lifestyle changes plus added fruits and vegetables.4
Metformin(Glucophage) is a medication used to treat type 2 diabetes. This drug affects the action of insulin and is useful in reducing a number of the symptoms and complications of PCOS. Metformin has been shown to be useful in the management of irregular periods, ovulation induction, weight loss, as well as the prevention of type 2 diabetes and gestational diabetes mellitus in women with PCOS.
This review has some limitations. We used a methodological approach which was deductive and not consistent with traditional rationale for herbal selection. Our inclusion criteria for clinical studies were specific and relied upon our identification of herbal medicines with preclinical (laboratory based) evidence explaining the mechanisms of reproductive endocrinological effects in oligo/amenorrhoea, hyperandrogenism and PCOS. Clinical studies were excluded from this review due to the absence of evidence for whole herbal extracts. This was the case for Camellia sinensis (green tea) for which only one laboratory study investigated the effects of injecting epigallocatechin, a catechin found in green tea in animals [76]. High quality clinical evidence for Camellia sinensis was not presented in this review due to the absence of pre-clinical data explaining the mechanism for effect for the whole herbal extract [77]. Mentha spicata (spearmint) was another herbal medicine excluded from this review despite the availability of high quality clinical evidence demonstrating testosterone lowering effects in women with PCOS [78]. We found no laboratory evidence describing the mechanism of action for Mentha spicata in hyperandrogenism. Camilla sinensis and Mentha spicata are examples of herbal medicines excluded from this review due to not meeting the inclusion criteria. Studies investigating western herbal medicines excluded from this review are provided in Tables 3, ​,44 and ​and55.

Many assisted-reproduction techniques are available for women who have difficulty conceiving because of PCOS. Working with UChicago Medicine experts in reproductive endocrinology, the Center for Polycystic Ovary Syndrome offers a full spectrum of standard and innovative fertility therapies — from oral and injectible medications that stimulate ovulation to advanced in vitro fertilization techniques, including use of donor eggs.

Angela Grassi, a registered dietitian who also has PCOS, says that because women who are overweight are likely to experience more insulin resistance than those who are not, they can get locked into a cycle of weight gain. “The more weight you gain, the more corresponding insulin your body produces, and the more you continue to gain weight,” she said.


I smoke indoors and as long as you keep the window open and vacuum slightly more often there's no noticeable grime. You should clean your walls with cold water once a year or so to stop build-up of random crap regardless of whether you smoke. Tuna's grime has built up over years of neglect, smoking probably hasn't helped but it's mainly because she's nasty.
Obese women with PCOS may have an increased risk of congenital anomalies (heart and neural tube defects), gestational diabetes mellitus [odds ratio (OR) 2.94; 95% confidence interval (CI): 1.70-5.08], hypertensive disorders during pregnancy (OR 3.67; 95% CI: 1.98-6.81) [mainly preeclampsia (OR 3.47; 95% CI: 1.95-6.17)], miscarriages, preterm births (OR 1.75; 95% CI: 1.16-2.62), the need for intensive unit care (OR 2.31; 95% CI: 1.25-4.26), increased perinatal mortality (OR 3.07; 95% CI: 1.03-9.21) 11,12 and Caesarean delivery (OR 1.74; 95% CI: 1.38-2.11) 12. The risk for preterm births and preeclampsia appears to be associated with maternal hyperandrogenism 13.
A prospective, observational clinical trial examined the endocrine effects of Tribulus terrestris 750 mg per day, over five days in eight healthy women (aged 28–45). A significant increase in mean serum FSH concentration from 11 mIU/ml before treatment to 17.75 mIU/ml following treatment (P < 0.001) was demonstrated. Pre-treatment FSH levels returned following cessation of treatment (Table 1). Another clinical study evaluated the equivalence of Tribulus terrestris (Tribestan®) and pharmaceuticals for ovulation induction in women with oligo/anovular infertility (n = 148), [60]. During the three month follow up, ovulation rates were highest with epimestrol (74%), followed by Tribulus terrestris (60%), clomiphene (47%) and cyclofenil (24%). However, the evidence for Tribulus terrestris should be interpreted with caution due to risks for bias in clinical studies. One study was uncontrolled with a small number of healthy participants [56], the second study did not report baseline characteristics, methods for allocation to treatment groups and data were not statistically analysed [60] (Table 1).
He probably does, and is trying to "make it up" to her by buying her all these purses, makeup, etc. and giving her money. I dated a girl for a while who would always shit-talk her dad as being "abusive" and "a narcissist." She'd scream at him and throw literal tantrums whenever he'd try to ask her- politely, I might add- about possibly finding a job or coming to visit him, and he'd throw money and gifts at her to try to make her love him. (The twist here is that she turned out to be the abusive narcissist. Ha. Ha ha.)
Mid luteal (day 20) serum progesterone concentration before and after; treatment arm 2.46 (±0.70) to 9.69 (±6.34), p < 0.001. Placebo 1.99 (±0.65) to 2.34 (±0.59) p = 0.08. No description of the distribution of drop-outs or missing data. This suggests the potential imbalance between intervention and control and a possible over-exaggeration for treatment effect.
Contrary to the implication of “polycystic,” some women with the condition don’t have any cysts. A diagnosis requires only two of the following three criteria to be met: elevated levels of male sex hormones (which can cause excess hair growth, acne, and baldness), irregular or absent periods, and/or at least 12 follicular cysts on one or both ovaries.
Jump up ^ Legro, Richard S.; Arslanian, Silva A.; Ehrmann, David A.; Hoeger, Kathleen M.; Murad, M. Hassan; Pasquali, Renato; Welt, Corrine K.; Endocrine Society (December 2013). "Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline". The Journal of Clinical Endocrinology and Metabolism. 98 (12): 4565–4592. doi:10.1210/jc.2013-2350. ISSN 1945-7197. PMC 5399492. PMID 24151290.
Dr. Victor Luna completed his medical education at Escuela Autonoma de Ciencias Medicas de Centroamerica in San Jose, Costa Rica. He then participated in an internship at LSU Health Science Center where he later completed his residency in Internal Medicine where he served as the chief resident for his final year. Dr. Luna continued his education by completing a fellowship at University of South Florida.

PCOS is associated with multiple metabolic defects, including metabolic syndrome. Twice as many women with PCOS have metabolic syndrome as in the general population, and about one-half of women with PCOS are obese.1,9 The presence of PCOS is also associated with a fourfold increase in the risk of type 2 diabetes mellitus.10 There is an increased prevalence of nonalcoholic fatty liver disease,11,12 sleep apnea,13 and dyslipidemia14 in patients with PCOS, even when controlled for body mass index. Rates of cardiovascular disease are higher in patients with PCOS, but increased cardiovascular mortality has not been consistently demonstrated.15,16 Finally, there is evidence to suggest an increased risk of mood disorders among patients with PCOS.17,18


Polycystic ovary syndrome (PCOS) is a complex, common reproductive and endocrine disorder affecting up to 17.8% of reproductive aged women [1]. Medical management places strong emphasis on a multidisciplinary approach as pharmaceutical treatments appear to be only moderately effective in treating individual symptoms [2, 3]. Conventional pharmaceutical management is limited by the prevalence of contraindications in women with PCOS [3], non-effectiveness in some circumstances [4], side effects [5] and by preferences of women with PCOS for alternatives to pharmaceutical management [6]. This review examines the mechanisms of effect for a potential alternative treatment, herbal medicine, and reveals six herbal medicines with both pre-clinical and clinical data explaining the reproductive endocrinological effects in PCOS and associated oligo/amenorrhoea and hyperandrogenism.
Traditionally, women with polycystic ovary syndrome (PCOS) have been treated with therapies aimed at relieving specific PCOS symptoms or health risks. Newer treatments being investigated at the University of Chicago Medicine and elsewhere also aim to address what may be a root cause of PCOS: insulin resistance. Many of these new therapies are designed to lower insulin levels, thus reducing production of testosterone.

If you’ve been told you have PCOS, you may feel frustrated or sad. You may also feel relieved that at last there is a reason and treatment for the problems you have been having, especially if you have had a hard time keeping a healthy weight, or you have excess body hair, acne, or irregular periods. Having a diagnosis without an easy cure can be difficult. However, it’s important for girls with PCOS to know they are not alone. Finding a health care provider who knows a lot about PCOS and is someone you feel comfortable talking to is very important. Keeping a positive attitude and working on a healthy lifestyle even when results seem to take a long time is very important, too! Many girls with PCOS tell us that talking with a counselor about their concerns can be very helpful. Other girls recommend online chats. The Center for Young Women’s Health offers a free and confidential monthly online chat for girls and young women with PCOS.
Androgens. All females make androgens (also referred to as “male hormones”), but there are often higher levels of androgens in women with PCOS. The excess androgens are produced mostly by the ovaries, but the adrenal glands can also be involved. Excess androgens are responsible for many PCOS symptoms including acne, unwanted hair, thinning hair, and irregular periods.
Kamel [67] Randomised controlled trial with an active control group. Comparative effectiveness trial for ovulation induction in women with PCOS. Three menstrual cycles. Women aged 21–27 with primary or secondary infertility. Diagnosis of PCOS by ultrasound and clinical history (n = 100). Gynaecology outpatient clinic. Two groups. Group one (n = 50) received Clomiphene citrate 100 mg days 2–7 of the menstrual cycle; group two (n = 50) received 20 mg Cimicifuga racemosa for days 2–12 of the menstrual cycle. Cimicifuga racemosa extract Klimadynon® by Bionorica, Neumarkt i.d. OBF Germany. 20 mg twice daily days 2–12 of menstrual cycle Clomiphene citrate (clomiphene) 100 mg daily for days 2–7 of menstrual cycle. Trigger injection (Human chorionic gonadotropin Pregnyl) and timed intercourse recommended when dominant follicle (>18 mm) was observed on ultrasound. Serum measurements during follicular phase for FSH, LH and FSH:LH ratio. Mid luteal progesterone. Ultrasound observation of endometrial thickness. Pregnancy rates including twin pregnancies. Adverse events including hyperstimulation. Positive outcomes for Cimicifuga racemosa compared to clomiphene for reduced day 2–5; LH (p = 0.007) and improved FSH to LH ratio (p = 0.06), mid luteal progesterone (p = 0.0001), endometrial thickness (p = 0.0004). Pregnancy rates were higher in the Cimicifuga racemosa group (7/50 compared to 4/50) but not statistically significant (p = 0.1). Adverse events (4 women) and twin pregnancy’s (two women) were not significantly different between groups. No detail for diagnostic criteria for PCOS. Confounding fertility factors not described. Drop-out reasons were not reported seven in Cimicifuga racemosa group and four in clomiphene group.
PCOS is a multifaceted syndrome that affects multiple organ systems with significant metabolic and reproductive manifestations. Treatment should be individualized based on the patient's presentation and desire for pregnancy (Figure 219,29–35). Devices and medications used to treat manifestations of PCOS, and their associated adverse effects, are described in Table 2.19,29–33,36
The advantages of CC use are low cost, oral administration, few side effects (flushing, headache, visual disturbances and abdominal discomfort), the induction of monofollicular development in most cases 16 and a low rate of multiple gestations (2 to 13%) 17. The initial dose is 50 mg/day for five days (starting between the second and fifth day of the menstrual cycle) and may be increased to 150 mg/day 17,18; however, doses greater than 100 mg/day usually do not offer additional benefits (may be useful in obese women) 18. The ovulation rate may reach 75 to 80% 19 with a conception rate of 22% per cycle 20 and a cumulative pregnancy rate between 60 and 70% in six cycles 9. There is no evidence that the administration of human chorionic gonadotropin (hCG) in the mid-cycle increases ovulation rates (OR 0.99; 95% CI: 0.36-2.77) or clinical pregnancy (OR 1.02; 95% CI: 0.56-1.89) 21,22. CC treatment should be limited to six ovulatory cycles and US monitoring is not mandatory (it is recommended only in the first ovulatory cycle to adjust the dose based on the ovarian follicular growth and development and for endometrial assessment) 17,18. Additional cycles of ovulation induction with CC (maximum of twelve cycles) may be individually evaluated based on the cost-effectiveness and age of women and after discussion with the couple 9. The incidence of ovarian hyperstimulation syndrome (OHSS; increased capillary permeability with consequent third-space fluid sequestration and hemoconcentration) associated with the use of CC is low, approximately 1 to 6% 17,23.
I actually felt really sad for her on a tumblr post once and gave her a spare fiver. the old dude seems to be the light of her life but hes always oding and shes always alone shooting up in public parks. the lack of hygiene seems to be like an "i dont feel human enough to be clean" thing. She's just so saddening I can't bring myself to laugh at all.
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