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BACKGROUND INFORMATION

One out of every 10 women is diagnosed with polycystic ovary syndrome (PCOS). This is a condition characterised by irregular and or infrequent menstrual cycles, physical signs of excess androgens such as acne, excess hair growth or hair loss, and a cystic appearance of ovaries on ultrasound scan. A proportion of these women struggle to conceive due to irregular or absence of ovulation (anovulation).  In the long term, it increases the risk of womb cancer, type 2 diabetes, and heart problems.

The current guidelines recommend weight loss as a first line treatment option to improve menstrual regularity and achieve pregnancy in women with anovulatory PCOS, trying to conceive. However, weight loss as a treatment option is not supported with strong evidence. It is also known to be associated with challenges with achieving and maintenance of the target weight. The medicines for ovulation induction include clomiphene citrate (clomid), letrozole or combination of them with metformin. If clomid/letrozole tablet is given, ultrasound monitoring is necessary, and it is not advisable to continue the treatment for longer than 6 months (may be considered up to 12 months). Metformin is also associated with significant gastro-intestinal side effects.

Myo-inositol is a nutritional supplement and studies have shown that in women with anovulatory PCOS, treatment with inositol increases frequency of menstrual cycles and doubles the ovulation rate. Therefore, there is a potential to use myo-inositol as a first line treatment option for ovulation induction in women with anovulatory PCOS, who are trying to conceive.

We are planning a research trial looking at Myo-inositol taken on its own and taken with letrozole/clomid as a fertility treatment option for women with PCOS, struggling to conceive. We would like your views on this subject, which will help us to develop the trial design of the study. 

The questions in this survey are about your views on women with PCOS who are struggling to conceive. It should take no more than 5 minutes to complete.  Participation is anonymous. 

If you would like further advice or information you can contact us on the email "j.pundir@qmul.ac.uk".


Question Title

* 1. Consider my participation in the survey as my consent

Question Title

* 2. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS:

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
1) struggle with irregular/infrequent menstrual cycles (anovulatory cycles)
2) struggle with weight loss or maintenance of weight
3) struggle to get pregnant

Question Title

* 3. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS are:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) aware of the risks of irregular/infrequent menstrual cycles
2) aware of risk of subfertility (struggle to get pregnant)
3) aware of increased risk of diabetes in pregnancy
4) aware of long-term health issues such as diabetes

Question Title

* 4. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) consider, inability to get pregnant is an important issue
2) are aware of the treatment options for subfertility

Question Title

* 5. As per your understanding, treatments generally offered to women with PCOS, to achieve pregnancy are (can choose more than one option):

Question Title

* 6. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) are aware of the benefit of 5% loss of body weight to get regular menstruation/ovulation and to get pregnant
2) feel that the option of weight loss is easily achievable and can be maintained

Question Title

* 7. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS are aware of:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) the use of clomid tablets and need for monitoring with ultrasound scan to achieve ovulation and pregnancy
2) the fact that the clomid tablets can be used for only 6-12 cycles
3) the use of letrozole tablets and need for monitoring with ultrasound scan to achieve ovulation and pregnancy
4) the use of metformin tablets and its side effects in terms of bloating.
5) the fact that the side effects of metformin, makes it difficult to continue

Question Title

* 8. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS may consider:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) the benefits of myo-inositol in improving ovulation and achieving pregnancy needs to be studied
2) it will be easier to take myo-inositol than diet and exercise to lose weight
3) that, if trying to conceive, they are more likely to take myo-inositol than could adhere to diet and exercise to achieve weight loss

Question Title

* 9. Using the scale provided, please indicate your level of agreement with the following statements by ticking the appropriate box.
Women with PCOS struggling to conceive due to infrequent periods:

  Strongly disagree Disagree Neither agree or disagree Agree Strongly agree
1) who have tried clomid, letrozole or metformin tablets to improve ovulation, would like to try alternative medicine such as myo-inositol
2) would be willing to take part in a study on benefits of Myo-inositol taken to improve ovulation and achieve pregnancy.
3) if conceive, whilst taking, myo-inositol, would be willing to continue to take this through the pregnancy to see its benefit in reducing Gestational diabetes.
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