Patient-tailored conventional ovulation induction algorithms in anovulatory infertility

Santbrink, Evert J. P. van; Eijkemans, Marinus J.C.; Laven, Joop S.E.; Fauser, Bart C.J.M.

doi:10.1016/j.tem.2005.08.006

Cited by 33 publications

(13 citation statements)

References 41 publications

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“…A clinical/biochemical parameter is expected to help in selecting a specific type of ovulation induction protocol most suitable for achieving improved ovulation and pregnancy rates in such women. It is also suggested that ovulation induction efficiency might improve if patient subgroups with altered chances for success or complications with new or conventional techniques could be identified [30]. In the present study, rFSH alone, or in combination with CC, appears to be the most effective protocol when baseline E 2 lies between 30-60 pg/ml.…”

Section: Discussionmentioning

confidence: 60%

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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Purpose Letrozole, though reported to be an effective ovulation inducing agent, warrants larger randomized trials. The purpose of this study is to compare the efficacy of letrozole with that of rFSH and clomiphene citrate(CC)/rFSH for ovarian stimulation in IUI cycles. Methods Randomized, prospective, single-blinded clinical trial. 1387 PCOS women after CC failure were randomized into three groups: Group A received letrozole, Group B received CC with two doses rFSH and Group C received continuous rFSH day 2 onwards until hCG injection. Results Group A, B and C had an ovulation rate of 79.30%, 56.95% and 89.89% and cycle cancellation rate of 20.70%, 43.05% and 10.11%, respectively. Pregnancy rates in Group A, B and C were 23.39%, 14.35% and 17.92%, while the miscarriage rates were 13.80%, 16.67% and 14.52%, respectively. Conclusion Letrozole appears to be a suitable ovulation inducing agent in PCOS women with CC failure and is found to be most effective when baseline estradiol level >60 pg/ml.

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Section: Discussionmentioning

confidence: 60%

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Ganesh

Goswami

Chattopadhyay

et al. 2009

J Assist Reprod Genet

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show abstract

“…The fact that under the new diagnostic criteria, the prevalence of metabolic disturbances and androgen excess becomes decreased and may also have consequences on the way women with PCOS will behave in ovulation induction treatment. From several reports in the recent literature, it has been shown that next to factors like higher female age and longer duration of infertility, hyperandrogenism and overweight will substantially reduce the chances for success in the establishment of ovulation and pregnancy 34,52–57 . As many of the new PCOS cases do not have androgen excess and tend to have lower rates of obesity and hyperinsulinaemia, they may be expected to respond better to ovulation induction regimens.…”

Section: Discussionmentioning

confidence: 99%

“…This eventually will result in more pronounced disturbance of ovarian function, exemplified by a higher rate of amenorrhoea in obese women with PCOS 14 . Moreover, it has been shown that in obese women with PCOS and more severe cycle disturbance, there is need for higher dosages of ovulation induction drugs and an increased risk of nonresponse to such treatment 34–36 …”

Section: Introductionmentioning

confidence: 99%

PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO‐II anovulation and association with metabolic factors

Broekmans

Knauff

Valkenburg³

et al. 2006

BJOG

379

224

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Objective The current report aims to compare the prevalence of polycystic ovary syndrome (PCOS) diagnosed according to the new Rotterdam criteria (Rott-PCOS) versus the previous criteria as formulated by the National Institutes of Health (NIH) (NIH-PCOS) in women with normogonadotropic (WHO-II) anovulation and assess the frequency of obesity and related factors determined in these women.Design Cohort study based on large anovulation screening database.Setting Two large tertiary referral centres for reproductive medicine.Population WHO-II normogonadotropic, anovulatory, infertility cases.Methods WHO-II cases were extracted from the screening database and classified according to both the Rotterdam and NIH criteria for PCOS. Within these two classes, the prevalence of obesity, hyperglycaemia and insulin resistance was assessed and compared and their relation to the difference in diagnostic criteria applied was analysed.Main outcome measures Prevalence of diagnosis PCOS in the WHO-II anovulation group. Prevalence of obesity, hyperglycaemia and insulin resistance in the two diagnostic classes.Results The Rott-PCOS group appeared to be more than 1.5 times larger than the group classified as NIH-PCOS (91 versus 55% of the WHO-II cohort). Especially, women with ovarian dysfunction and polycystic ovaries at ultrasound scan, but without hyperandrogenism, were added to the PCOS diagnostic group. The Rott-PCOS exhibited a lower frequency of obesity, hyperglycaemia and insulin resistance compared with the NIH-PCOS group. Obese women in the Rott-PCOS group without androgen excess had a different metabolic profile compared with obese women in the NIH-PCOS group, with lower rates of hyperglycaemia and hyperinsulinism, despite comparable distributions of body weight. ConclusionThe present findings indicate that with the new Rotterdam consensus criteria, oligo/anovulatory women with less severe metabolic derangement will be added to the heterogeneous group of women with PCOS.Keywords Consensus, hyperglycaemia, insulin resistance, PCOS, WHO-II.Please cite this paper as: Broekmans F, Knauff E, Valkenburg O, Laven J, Eijkemans M, Fauser B. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors.

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“…Multivariate models have been developed predicting ovulation and pregnancy after CC (35) and chances for success and complications from use of gonadotropins (10,153) and LOS. These observations need to be confirmed in independent patient populations.…”

Section: General Commentsmentioning

confidence: 99%

Consensus on infertility treatment related to polycystic ovary syndrome

Thessaloniki¹,

Greece²

2008

Fertility and Sterility

621

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Patient-tailored conventional ovulation induction algorithms in anovulatory infertility

Cited by 33 publications

References 41 publications

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO‐II anovulation and association with metabolic factors

Consensus on infertility treatment related to polycystic ovary syndrome

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