title: Endocrine methods of ovulation induction.
abstract: The rationale of ovulation induction is to achieve the development of a single follicle and ultimately a singleton healthy baby. Problems faced by women with anovulatory polycystic ovary syndrome are the sensitivity of the ovary to stimulation and health issues such as obesity. This chapter will discuss medical management including strategies to lose weight, address hyperinsulinaemia with insulin-sensitizing agents, such as metformin, and outline methods of ovulation induction from the usual first-line therapy of clomiphene citrate and the subsequent use of gonadotrophin therapy in clomiphene-resistant patients. Appropriately directed surgical ovulation induction with laparoscopic ovarian diathermy appears to be as efficacious as gonadotrophin therapy but will not be discussed in the context of this chapter.
authors.affiliation: Department of Obstetrics and Gynaecology, General Infirmary, Leeds, UK.
authors.forename: A
authors.initials: A
authors.lastname: Balen
mesh_terms: D000328:Adult; D000858:Anovulation / Q000188:drug therapy / Q000209:etiology*; D002996:Clomiphene / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy; D013629:Tamoxifen / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D004965:Estrogen Antagonists; D006062:Gonadotropins; D013629:Tamoxifen; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone