title: Patient-tailored conventional ovulation induction algorithms in anovulatory infertility.
abstract: Conventional treatment of normogonadotropic anovulatory infertility is ovulation induction using the antiestrogen clomiphene citrate, followed by follicle-stimulating hormone. Multiple follicle development, associated with ovarian hyperstimulation, and multiple pregnancy remain the major complications. Cumulative singleton and multiple pregnancy rate data after different induction treatments are needed. Newer ovulation induction interventions, such as insulin-sensitizing drugs, aromatase inhibitors and laparoscopic ovarian electrocoagulation, should be compared with conventional strategies. Ovulation induction efficiency might improve if patient subgroups with altered chances for success or complications with new or conventional techniques could be identified, using multivariate prediction models based on initial screening characteristics. This would make ovulation induction more cost-effective, safe and convenient, enabling doctors to advise patients on the most effective and patient-tailored treatment strategy.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. e.vansantbrink@erasmusmc.nl
authors.forename: Evert J P
authors.initials: EJ
authors.lastname: van Santbrink
authors.forename: Marinus J
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Joop S E
authors.initials: JS
authors.lastname: Laven
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
mesh_terms: D000465:Algorithms; D000858:Anovulation / Q000188:drug therapy*; D002996:Clomiphene / Q000627:therapeutic use; D004564:Electrocoagulation; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000145:classification / Q000188:drug therapy*; D007333:Insulin Resistance / Q000502:physiology; D008687:Metformin / Q000627:therapeutic use; D010049:Ovarian Diseases / Q000601:surgery; D010062:Ovulation Induction / Q000191:economics / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology; D011247:Pregnancy
chemical_list: D006062:Gonadotropins; D002996:Clomiphene; D005640:Follicle Stimulating Hormone; D008687:Metformin