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Ovulation induction in polycystic ovary syndrome.
Minerva Ginecol. 2008 Feb; 60(1):53-61.MG

Abstract

Management of polycystic ovary syndrome (PCOS) usually spans a woman's reproductive years. While treatment of androgenic symptoms is often a primary concern, periodically, the regimen has to be modified because of a desire for pregnancy. As these women are usually anovulatory, ovulation induction is generally required. The premise on which ovulation induction in PCOS is based is two-fold: increasing ovarian exposure to follicle stimulating hormone (FSH) and/or correcting hormonal derangements. Potential differences in pathogenesis, evidenced clinically by phenotypic diversity, suggest that treatment should be individualized. This paper is an overview of treatments available and also provides a critical appraisal of management options. These options include the use of clomiphene citrate, insulin sensitizers, and the combination. Protocols for ovulation induction with FSH injections are outlined and the relative risks of multiple gestation and severe ovarian hyperstimulation syndrome of these various protocols discussed. The use of aromatase inhibitors and the occasional use of glucocorticoids are briefly reviewed. Finally, the role of laparoscopic ovarian diathermy in the management of anovulatory infertility in PCOS is outlined.

Authors+Show Affiliations

Nader S
Department of Obstetrics and Gynecology, University of Texas Medical School, Houston, TX 77030, USA. shahla.nader-eftekhari@uth.tmc.edu

MeSH

AdultAnovulationAromatase InhibitorsBody Mass IndexClomipheneDiathermyFemaleFertility Agents, FemaleFollicle Stimulating HormoneGlucocorticoidsHumansHyperandrogenismHypoglycemic AgentsInsulin ResistanceLaparoscopyLetrozoleMetforminNitrilesOvulation InductionPhenotypePolycystic Ovary SyndromePregnancyRandomized Controlled Trials as TopicTime FactorsTriazoles

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

18277352

Citation

Nader, S. "Ovulation Induction in Polycystic Ovary Syndrome." Minerva Ginecologica, vol. 60, no. 1, 2008, pp. 53-61.
Nader S. Ovulation induction in polycystic ovary syndrome. Minerva Ginecol. 2008;60(1):53-61.
Nader, S. (2008). Ovulation induction in polycystic ovary syndrome. Minerva Ginecologica, 60(1), 53-61.
Nader S. Ovulation Induction in Polycystic Ovary Syndrome. Minerva Ginecol. 2008;60(1):53-61. PubMed PMID: 18277352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovulation induction in polycystic ovary syndrome. A1 - Nader,S, PY - 2008/2/16/pubmed PY - 2008/6/28/medline PY - 2008/2/16/entrez SP - 53 EP - 61 JF - Minerva ginecologica JO - Minerva Ginecol VL - 60 IS - 1 N2 - Management of polycystic ovary syndrome (PCOS) usually spans a woman's reproductive years. While treatment of androgenic symptoms is often a primary concern, periodically, the regimen has to be modified because of a desire for pregnancy. As these women are usually anovulatory, ovulation induction is generally required. The premise on which ovulation induction in PCOS is based is two-fold: increasing ovarian exposure to follicle stimulating hormone (FSH) and/or correcting hormonal derangements. Potential differences in pathogenesis, evidenced clinically by phenotypic diversity, suggest that treatment should be individualized. This paper is an overview of treatments available and also provides a critical appraisal of management options. These options include the use of clomiphene citrate, insulin sensitizers, and the combination. Protocols for ovulation induction with FSH injections are outlined and the relative risks of multiple gestation and severe ovarian hyperstimulation syndrome of these various protocols discussed. The use of aromatase inhibitors and the occasional use of glucocorticoids are briefly reviewed. Finally, the role of laparoscopic ovarian diathermy in the management of anovulatory infertility in PCOS is outlined. SN - 0026-4784 UR - https://www.unboundmedicine.com/medline/citation/18277352/Ovulation_induction_in_polycystic_ovary_syndrome_ DB - PRIME DP - Unbound Medicine ER -