A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome

Medical Sciences

Hayden Homer¹  Eszter Vanky²  Jie Qiao³  Luk Rombauts⁴  Roger Hart⁵  Cailin Jordan⁶  Rhonda Garad⁷  Helena J. Teede⁸  Edgar Mocanu⁹  William Ledger^1,10  Michael Costello^1,10  Christos Venetis^1,10  Louise Johnson^1,11 

[1] Christopher Chen Oocyte Biology Research Laboratory, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, Australia;Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 1517 Trondheim, Norway;Department of Obstetrics and Gynaecology, Medical Center for Human Reproduction, Peking University Third Hospital, Beijing 100191, China;Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia;Division of Obstetrics and Gynaecology, The University of Western Australia, University of Western Australia, Crawley, WA 6008, UK;Genea Hollywood Fertility, Wembley 6014, Australia;Monash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University, and Monash Health, Melbourne, VIC 3168, Australia;National Health and Medical Research Council Centre for Research Excellence in PCOS, Monash University, Melbourne, VIC 3168, Australia;Royal College of Surgeons, Rotunda Hospital, Dublin D02 YN77, Ireland;University of New South Wales, High St, Kensington, Sydney, NSW 2033, Australia;Victorian Assisted Reproductive Treatment Authority, Melbourne, VIC 3000, Australia;

关键词: polycystic ovary syndrome;    infertility;    treatment;    ovulation induction;   

DOI  :  10.3390/medsci7090095

来源: DOAJ

【 摘 要 】

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line medical ovulation induction therapy to improve fertility outcomes is letrozole, whilst other less efficacious ovulation induction agents, such as clomiphene citrate, metformin, and metformin combined with clomiphene citrate, may also be considered. Metformin combined with clomiphene citrate is more effective than clomiphene citrate alone. In obese women with PCOS, clomiphene citrate could be used in preference to metformin alone whilst clomiphene citrate could be added to metformin alone in order to improve reproductive outcome in all women with PCOS. Gonadotrophins, which are more effective than clomiphene citrate in therapy naïve women with PCOS, can be considered a first line therapy in the presence of ultrasound monitoring, following counselling on the cost and the potential risk of multiple pregnancy.

【 授权许可】

Unknown