Ovulation induction: a mini review.
Ovulation induction is the method for treating anovulatory infertility. For patients with hypogonadotrophic hypogonadism, the treatment involves administration of both FSH and LH, while HCG is injected for follicle rupture. Pulsatile GnRH has the same effectiveness as gonadotrophins and the advantage of the low multiple pregnancy rate. In polycystic ovary syndrome (PCOS), the first treatment choice is clomiphene citrate. With this drug, in properly selected patients, the cumulative pregnancy rate approaches that of normal women. Low-dose protocols of FSH are the second line of treatment, effective in inducing monofollicular development. Laparoscopic ovarian drilling can be an alternative but not as a first choice treatment in clomiphene-resistant patients. Other treatments, such as pulsatile GnRH and GnRH agonists, are hardly used today in PCOS. However, in obese women with PCOS, weight loss and exercise should be recommended as the first line of therapy. Newer agents including aromatase inhibitors and insulin sensitizers, although promising, need further evaluation.
Messinis
Ioannis E
IE
Department of Obstetrics and Gynaecology, University of Thessalia, Medical School, Larissa, Greece. messinis@med.uth.gr
D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001835:Body Weight; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use; D015444:Exercise; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007328:Insulin / Q000378:metabolism; D010535:Laparoscopy; D007986:Luteinizing Hormone / Q000627:therapeutic use; D010053:Ovary / Q000601:surgery; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011994:Recombinant Proteins / Q000627:therapeutic use; D015431:Weight Loss
D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D020847:Estrogen Receptor Modulators; D007328:Insulin; D011994:Recombinant Proteins; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone