Infertility Treatment in Polycystic Ovary Syndrome: Lifestyle Interventions, Medications, and Surgery

The document from 2013 addresses infertility treatments in women with Polycystic Ovary Syndrome (PCOS), highlighting lifestyle changes as the initial approach, followed by pharmacological and surgical options. It recommends weight loss, increased exercise, smoking cessation, and reduced alcohol consumption before medication. Clomiphene citrate, often combined with metformin, is the first-line drug treatment, with gonadotropins and laparoscopic ovarian drilling as second-line treatments, and in vitro fertilization as a third-line option. The document notes that 72% of cases using clomiphene or gonadotropins result in a single live birth, and 50% for laparoscopic ovarian drilling. It also mentions that 38-88% of women with PCOS are overweight or obese, which is associated with metabolic disorders like type 2 diabetes. Orlistat and bariatric surgery are discussed as weight loss interventions, with small studies (n = 24 and 17) showing positive outcomes. The document does not provide specific numbers for the overall studies or treatments discussed, except for the small studies on bariatric surgery.