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

Overview

Journal Med Sci (Basel)

Specialty General Medicine

Date 2019 Sep 13

PMID 31510088

Citations 9

Authors

Michael Costello

Rhonda Garad

Roger Hart

Hayden Homer

Louise Johnson

Cailin Jordan

Edgar Mocanu

Jie Qiao

Luk Rombauts

Helena J Teede

Eszter Vanky

Christos Venetis

William Ledger

Affiliations

Soon will be listed here.

Abstract

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.

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