A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line me...
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| Format: | Article |
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MDPI AG
2019-09-01
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| Series: | Medical Sciences |
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| Online Access: | https://www.mdpi.com/2076-3271/7/9/95 |
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| author | Michael Costello Rhonda Garad Roger Hart Hayden Homer Louise Johnson Cailin Jordan Edgar Mocanu Jie Qiao Luk Rombauts Helena J. Teede Eszter Vanky Christos Venetis William Ledger |
| author_facet | Michael Costello Rhonda Garad Roger Hart Hayden Homer Louise Johnson Cailin Jordan Edgar Mocanu Jie Qiao Luk Rombauts Helena J. Teede Eszter Vanky Christos Venetis William Ledger |
| author_sort | Michael Costello |
| collection | DOAJ |
| description | Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line medical ovulation induction therapy to improve fertility outcomes is letrozole, whilst other less efficacious ovulation induction agents, such as clomiphene citrate, metformin, and metformin combined with clomiphene citrate, may also be considered. Metformin combined with clomiphene citrate is more effective than clomiphene citrate alone. In obese women with PCOS, clomiphene citrate could be used in preference to metformin alone whilst clomiphene citrate could be added to metformin alone in order to improve reproductive outcome in all women with PCOS. Gonadotrophins, which are more effective than clomiphene citrate in therapy naïve women with PCOS, can be considered a first line therapy in the presence of ultrasound monitoring, following counselling on the cost and the potential risk of multiple pregnancy. |
| first_indexed | 2024-12-21T11:52:16Z |
| format | Article |
| id | doaj.art-addbc87c14fa462ea32038193601a244 |
| institution | Directory Open Access Journal |
| issn | 2076-3271 |
| language | English |
| last_indexed | 2024-12-21T11:52:16Z |
| publishDate | 2019-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medical Sciences |
| spelling | doaj.art-addbc87c14fa462ea32038193601a2442022-12-21T19:05:01ZengMDPI AGMedical Sciences2076-32712019-09-01799510.3390/medsci7090095medsci7090095A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary SyndromeMichael Costello0Rhonda Garad1Roger Hart2Hayden Homer3Louise Johnson4Cailin Jordan5Edgar Mocanu6Jie Qiao7Luk Rombauts8Helena J. Teede9Eszter Vanky10Christos Venetis11William Ledger12University of New South Wales, High St, Kensington, Sydney, NSW 2033, AustraliaMonash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University, and Monash Health, Melbourne, VIC 3168, AustraliaDivision of Obstetrics and Gynaecology, The University of Western Australia, University of Western Australia, Crawley, WA 6008, UKChristopher Chen Oocyte Biology Research Laboratory, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, AustraliaVictorian Assisted Reproductive Treatment Authority, Melbourne, VIC 3000, AustraliaGenea Hollywood Fertility, Wembley 6014, AustraliaRoyal College of Surgeons, Rotunda Hospital, Dublin D02 YN77, IrelandDepartment of Obstetrics and Gynaecology, Medical Center for Human Reproduction, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Obstetrics and Gynaecology, Monash University, Melbourne 3168, AustraliaNational Health and Medical Research Council Centre for Research Excellence in PCOS, Monash University, Melbourne, VIC 3168, AustraliaDepartment of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 1517 Trondheim, NorwayUniversity of New South Wales, High St, Kensington, Sydney, NSW 2033, AustraliaUniversity of New South Wales, High St, Kensington, Sydney, NSW 2033, AustraliaPolycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line medical ovulation induction therapy to improve fertility outcomes is letrozole, whilst other less efficacious ovulation induction agents, such as clomiphene citrate, metformin, and metformin combined with clomiphene citrate, may also be considered. Metformin combined with clomiphene citrate is more effective than clomiphene citrate alone. In obese women with PCOS, clomiphene citrate could be used in preference to metformin alone whilst clomiphene citrate could be added to metformin alone in order to improve reproductive outcome in all women with PCOS. Gonadotrophins, which are more effective than clomiphene citrate in therapy naïve women with PCOS, can be considered a first line therapy in the presence of ultrasound monitoring, following counselling on the cost and the potential risk of multiple pregnancy.https://www.mdpi.com/2076-3271/7/9/95polycystic ovary syndromeinfertilitytreatmentovulation induction |
| spellingShingle | Michael Costello Rhonda Garad Roger Hart Hayden Homer Louise Johnson Cailin Jordan Edgar Mocanu Jie Qiao Luk Rombauts Helena J. Teede Eszter Vanky Christos Venetis William Ledger A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome Medical Sciences polycystic ovary syndrome infertility treatment ovulation induction |
| title | A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome |
| title_full | A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome |
| title_fullStr | A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome |
| title_full_unstemmed | A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome |
| title_short | A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome |
| title_sort | review of first line infertility treatments and supporting evidence in women with polycystic ovary syndrome |
| topic | polycystic ovary syndrome infertility treatment ovulation induction |
| url | https://www.mdpi.com/2076-3271/7/9/95 |
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