Fertility treatment in women with polycystic ovary syndrome: a decision analysis of different oral ovulation induction agents.
OBJECTIVE
To compare different oral ovulation induction agents in treating infertile women with polycystic ovary syndrome (PCOS).


METHODS
Decision-analytic model comparing three treatment strategies using probability estimates derived from literature review and sensitivity analyses performed on the baseline assumptions.


METHODS
Outpatient reproductive medicine and gynecology practices.


METHODS
Infertile women with PCOS.


METHODS
Metformin, clomiphene citrate, or metformin with clomiphene citrate.


METHODS
Live birth.


RESULTS
Within the baseline assumptions, combination therapy with metformin and clomiphene citrate was the preferred therapy for achieving live birth in women with PCOS. Sensitivity analysis revealed the model to be robust over a wide range of probabilities.


CONCLUSIONS
Combination therapy with metformin and clomiphene citrate should be considered as first-line treatment for infertile women with PCOS.
Jungheim
Emily S
ES
Department of Obstetrics and Gynecology, Washington University, St. Louis, Missouri 63108, USA. jungheime@wudosis.wustl.edu
Odibo
Anthony O
AO
D000284:Administration, Oral; D000328:Adult; D000465:Algorithms; D002996:Clomiphene / Q000008:administration & dosage* / Q000009:adverse effects; D003661:Decision Support Techniques; D004338:Drug Combinations; D005260:Female; D005298:Fertility / Q000187:drug effects; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D050498:Live Birth / Q000453:epidemiology; D008687:Metformin / Q000008:administration & dosage* / Q000009:adverse effects; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D011247:Pregnancy
D004338:Drug Combinations; D005300:Fertility Agents, Female; D002996:Clomiphene; D008687:Metformin
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