Ovulation induction--optimizing results and minimizing risks.
The aim of ovulation induction therapy should be, wherever possible, to correct the underlying disturbance and achieve safe, repeated unifollicular ovulation to achieve the live birth of singleton babies. This article outlines the main causes of anovulatory infertility but deals mostly with the management of anovulatory polycystic ovary syndrome (PCOS), which is the most common problem to confront specialists in reproductive medicine. PCOS is associated with insulin resistance, particularly in those who are overweight. Thus, strategies to achieve weight loss and improve insulin sensitivity, including the use of drugs such as metformin, enhance reproductive function. Therapies to induce ovulation involve first the use of the anti-oestrogen clomiphene citrate. For those who fail to ovulate in response to clomiphene citrate, the principal options include parenteral gonadotrophin therapy or laparoscopic ovarian diathermy.
Balen
Adam
A
Department of Reproductive Medicine, The General Infirmary, Leeds LS2 9NS, UK.
D000328:Adult; D000858:Anovulation / Q000209:etiology / Q000628:therapy*; D019090:Case Management; D002996:Clomiphene / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000191:economics; D005260:Female; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000188:drug therapy / Q000209:etiology; D007006:Hypogonadism / Q000188:drug therapy; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D007333:Insulin Resistance; D008297:Male; D017063:Outcome Assessment, Health Care; D010053:Ovary / Q000601:surgery; D050177:Overweight / Q000150:complications; D010062:Ovulation Induction / Q000009:adverse effects; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D055101:Semen Analysis; D012952:Societies
D006062:Gonadotropins; D002996:Clomiphene