Purpose To identify the leading treatment strategies for infertile women with PCOS on an international scale. Methods A retrospective evaluation using the results of a web-based survey, (IVF-Worldwide (www.IVF-worldwide. com), posted from 1 to 30 September 2010 was performed. Binomial confidence intervals for proportions were calculated by the modified Wald method with significance defined as P <0. 05 using a DataStar software package (DataStar, Waltham, MA, USA). Incomplete surveys were excluded from the analysis.
ResultsThe results from 262 centers in 68 nations were obtained. Clomiphene citrate was the clear first choice, 68 %, for PCOS treatment in the respondent group. Eightyeight percent of respondents utilized ultrasound follicular monitoring when conducting ovulation induction with oral medications. A significant (p <0.05) proportion of respondents (66 %) did use some BMI cutoff beyond which IVF treatment was not offered. The preferred IVF protocols for PCOS patients were gonadotropin releasing hormone (GnRH) antagonist, 46 %, and GnRH agonist, 51 %. There was heterogeneity of responses observed regarding the management of a patient at very high risk of OHSS. Conclusions While some advances, such as the use of GnRH antagonist regimen in IVF cycles, were relatively underutilized, the survey gives an unfiltered snapshot at the practice patterns of a large number of clinics. Results from this survey may be used by researchers and professional organizations to improve the clinical care of PCOS women suffering with infertility.