The treatment of infertility in polycystic ovary syndrome: a brief update.
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Lifestyle change alone is considered the first-line treatment for the management of infertile anovulatory PCOS women who are overweight or obese. First-line medical ovulation induction therapy to improve fertility outcomes is clomiphene citrate, whilst gonadotrophins, laparoscopic ovarian surgery or possibly metformin are second line in clomiphene citrate-resistant PCOS women. There is currently insufficient evidence to recommend aromatase inhibitors over that of clomiphene citrate in infertile anovulatory PCOS women in general or specifically in therapy naive or clomiphene citrate-resistant PCOS women. IVF/ICSI treatment is recommended either as a third-line treatment or in the presence of other infertility factors.
Obstetrics and Gynaecology, University of New South Wales, Sydney, NSW, Australia. mfcostello@unsw.edu.au
Michael F
MF
Costello
Marie L
ML
Misso
Jennifer
J
Wong
Roger
R
Hart
Luk
L
Rombauts
Angela
A
Melder
Robert J
RJ
Norman
Helena J
HJ
Teede
D000328:Adult; D000858:Anovulation / Q000209:etiology / Q000628:therapy*; D002996:Clomiphene / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000150:complications*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000628:therapy*
D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene; D008687:Metformin