ALGORITHM OF OVULATION INDUCTION IN PATIENTS WITH POLYCISTIC OVARY SYNDROME

Med Pregl. 2016 Jan-Feb;69(1-2):25-30. doi: 10.2298/mpns1602025b.

Abstract

Introduction: Polycystic ovary syndrome is the most frequent endocrine disturbance in the reproductive period of women's life and the most frequent cause of anovulatory infertility. Ovulation and pregnancy in patients having polycystic ovary syndrome may be a result of a wide range of therapeutic options, and the treatment assumes a gradual approach--from simple noninvasive to expensive and demanding procedures.

Material and methods: A systematic literature survey concerning the efficiency of particular ovulation induction methods in respect of the reproductive outcome was carried out with the aim of establishing the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome. The search was confined to clinical investigations performed on human subjects, reported in English in the period from the beginning of 2010 to June of 2014.

Conclusion: As a conclusion of this systematic survey of the efficiency of ovulation induction methods, which confirms and supplements the knowledge in this field, it is possible to form the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome, consisting of the following subsequent steps: 1) modification of life style, 2) induction with clomiphene citrate 3) use of metformin, 4) use ofaromatase inhibitors, 5) application ofgonadotropins and laparoscopic ovarian drilling--as a second-line treatment, and 6) assisted reproductive techniques.

Publication types

  • Review

MeSH terms

  • Algorithms*
  • Aromatase Inhibitors / therapeutic use*
  • Clomiphene / therapeutic use
  • Female
  • Fertility Agents, Female / therapeutic use*
  • Gonadotropins / therapeutic use*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Infertility, Female / drug therapy*
  • Infertility, Female / etiology
  • Letrozole
  • Metformin / therapeutic use
  • Nitriles / therapeutic use
  • Ovulation Induction / methods*
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / drug therapy*
  • Pregnancy
  • Reproductive Techniques, Assisted
  • Triazoles / therapeutic use

Substances

  • Aromatase Inhibitors
  • Fertility Agents, Female
  • Gonadotropins
  • Hypoglycemic Agents
  • Nitriles
  • Triazoles
  • Clomiphene
  • Letrozole
  • Metformin