title: Evaluation and treatment of anovulatory and unexplained infertility.
abstract: Anovulatory disorders are a primary cause of female infertility. Polycystic ovarian syndrome is the major cause of anovulation and is generally associated with obesity. Lifestyle changes to encourage weight loss are the initial therapy for overweight and obese patients, followed by clomiphene citrate for ovulation induction. For those patients who fail to ovulate on clomiphene citrate, alternatives, such as letrozole; gonadotropins; and complimentary agents to enhance clomiphene citrate, such as metformin and glucocorticoids, are reviewed. Women with unexplained infertility (no identifiable cause of infertility on a routine evaluation) may benefit from ovulation induction with clomiphene citrate, letrozole, or gonadotropins.
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Propst
authors.forename: G Wright
authors.initials: GW
authors.lastname: Bates
mesh_terms: D000858:Anovulation / Q000188:drug therapy* / Q000209:etiology; D002996:Clomiphene / Q000627:therapeutic use; D004032:Diet; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010535:Laparoscopy; D000077289:Letrozole; D008687:Metformin / Q000627:therapeutic use; D009570:Nitriles / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D040242:Risk Reduction Behavior; D014230:Triazoles / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D005300:Fertility Agents, Female; D005938:Glucocorticoids; D006062:Gonadotropins; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D000077289:Letrozole; D008687:Metformin