Polycystic Ovary Syndrome and Infertility: An Update

Polycystic ovarian syndrome (PCOS) is a prevalent endocrine disorder characterized by symptoms such as hyperandrogenism, irregular menstrual cycles, and insulin resistance, which can lead to infertility, insulin resistance, and type 2 diabetes. Treatment goals include reducing body weight and insulin levels, restoring fertility, controlling hair growth, maintaining regular menstrual cycles, and preventing complications. Metformin and thiazolidinediones are common treatments for insulin resistance in PCOS, with newer therapies like statins and incretins targeting metabolic aspects of the condition. Alternative treatments like vitamin D, acarbose, and myoinositol have also shown effectiveness. For infertility, clomiphene citrate has been the standard for ovulation induction, but aromatase inhibitors are now providing comparable or superior results. Advanced treatments include protocols using gonadotropins, gonadotropin-releasing hormone antagonists, ovarian drilling, and assisted reproductive technologies with in vitro oocyte maturation, reflecting significant therapeutic advancements in managing PCOS-related infertility.