Polycystic Ovary Syndrome: Diagnosis and Management of Related Infertility

    November 2012 in “ Obstetrics, Gynaecology & Reproductive Medicine ”
    Suresh Kini
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    TLDR Lifestyle changes and clomiphene are first-line treatments for infertility in women with PCOS, with other options available if these fail.
    The 2012 document reviews the diagnosis and management of infertility in women with polycystic ovary syndrome (PCOS), emphasizing lifestyle changes such as weight loss and exercise as the initial treatment, especially for overweight or obese women. Clomiphene citrate is recommended as the first-line pharmacological treatment for anovulatory infertility, with a conception rate of 67% over six months. If clomiphene fails, second-line treatments include gonadotropins, laparoscopic ovarian drilling, and potentially metformin combined with clomiphene, with in vitro fertilization as a third-line option. The document notes that while clomiphene induces ovulation in 70-80% of patients, only 40-50% conceive, and it discusses the side effects and mechanisms of various treatments. It also mentions the use of anti-obesity drugs and the importance of managing psychological factors to improve adherence to lifestyle interventions. The document calls for patient-tailored approaches to treatment and more research to fully understand PCOS.
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