Tags

Type your tag names separated by a space and hit enter

Reproductive impact of polycystic ovary syndrome.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to highlight the impact of polycystic ovary syndrome (PCOS) on menstrual function, fertility and reproductive outcomes. Women with PCOS often present with anovulation, menstrual disturbances and hyperandrogenism. Management options for the reproductive disorders of PCOS will be discussed.

RECENT FINDINGS

The role of metformin in treating PCOS is narrowing. New data show improved live birth rates by skipping a progestin withdrawal bleed and proceeding directly with a dose escalation of clomiphene for ovulation induction. The Pregnancy in PCOS trial II will determine the safety and efficacy of clomiphene citrate compared to letrozole, in achieving live birth in infertile women with PCOS.

SUMMARY

Initial treatment for reproductive disorders in overweight and obese women with PCOS is weight loss. This helps menstrual disturbances, shortens the time to conception and reduces adverse obstetric risks. Clomiphene citrate is considered the first-line therapy for ovulatory infertility. Clomiphene citrate-resistant women may be offered aromatase inhibitors or laparoscopic ovarian surgery. Metformin does not improve live birth rate or reduce miscarriage rate and is no longer considered an option for ovulation induction. Women with PCOS need to be counseled about risks of multiple gestations with gonadotropin therapy.

Authors+Show Affiliations

Center for Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina, USA. Rebecca.Usadi@carolinashealthcare.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23108198

Citation

Usadi, Rebecca S., and Richard S. Legro. "Reproductive Impact of Polycystic Ovary Syndrome." Current Opinion in Endocrinology, Diabetes, and Obesity, vol. 19, no. 6, 2012, pp. 505-11.
Usadi RS, Legro RS. Reproductive impact of polycystic ovary syndrome. Curr Opin Endocrinol Diabetes Obes. 2012;19(6):505-11.
Usadi, R. S., & Legro, R. S. (2012). Reproductive impact of polycystic ovary syndrome. Current Opinion in Endocrinology, Diabetes, and Obesity, 19(6), pp. 505-11. doi:10.1097/MED.0b013e328359ff92.
Usadi RS, Legro RS. Reproductive Impact of Polycystic Ovary Syndrome. Curr Opin Endocrinol Diabetes Obes. 2012;19(6):505-11. PubMed PMID: 23108198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproductive impact of polycystic ovary syndrome. AU - Usadi,Rebecca S, AU - Legro,Richard S, PY - 2012/10/31/entrez PY - 2012/10/31/pubmed PY - 2013/5/1/medline SP - 505 EP - 11 JF - Current opinion in endocrinology, diabetes, and obesity JO - Curr Opin Endocrinol Diabetes Obes VL - 19 IS - 6 N2 - PURPOSE OF REVIEW: The purpose of this review is to highlight the impact of polycystic ovary syndrome (PCOS) on menstrual function, fertility and reproductive outcomes. Women with PCOS often present with anovulation, menstrual disturbances and hyperandrogenism. Management options for the reproductive disorders of PCOS will be discussed. RECENT FINDINGS: The role of metformin in treating PCOS is narrowing. New data show improved live birth rates by skipping a progestin withdrawal bleed and proceeding directly with a dose escalation of clomiphene for ovulation induction. The Pregnancy in PCOS trial II will determine the safety and efficacy of clomiphene citrate compared to letrozole, in achieving live birth in infertile women with PCOS. SUMMARY: Initial treatment for reproductive disorders in overweight and obese women with PCOS is weight loss. This helps menstrual disturbances, shortens the time to conception and reduces adverse obstetric risks. Clomiphene citrate is considered the first-line therapy for ovulatory infertility. Clomiphene citrate-resistant women may be offered aromatase inhibitors or laparoscopic ovarian surgery. Metformin does not improve live birth rate or reduce miscarriage rate and is no longer considered an option for ovulation induction. Women with PCOS need to be counseled about risks of multiple gestations with gonadotropin therapy. SN - 1752-2978 UR - https://www.unboundmedicine.com/medline/citation/23108198/Reproductive_impact_of_polycystic_ovary_syndrome_ L2 - http://Insights.ovid.com/pubmed?pmid=23108198 DB - PRIME DP - Unbound Medicine ER -