Treatment Strategies for the Infertile Polycystic Ovary Syndrome Patient

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins. In CC treatment failure, Letrozole could be an alternative or treatment with gonadotropins. IVF is considered the third-line treatment; the 'short', antagonist-based protocol is the preferred option for PCOS patients, as it is associated with lower risk of developing ovarian hyperstimulation syndrome (specifically by using a gonadotropin--releasing hormone agonist as ovulation trigger), but with comparable outcomes as the long protocol.

Shaoyao-Gancao Decoction alleviated hyperandrogenism in a letrozole-induced rat model of polycystic ovary syndrome by inhibition of NF-κB activation

“…Polycystic ovary syndrome (PCOS), one of the most frequently reported endocrinopathies in women of reproductive age, is characterized by anovulation, hyperandrogenism, and polycystic ovaries syndrome [1,2]. Epidemiologic studies showed that PCOS affected 5–10% reproductive women and it was the leading cause of nearly 75% cases of anovulatory infertility [3]. In addition to the reproductive abnormalities, affected women are more likely to develop various clinical implications, including hyperandrogenism, cardiovascular disease, and endometrial carcinoma.…”

ETA-mediated anti-TNF-α therapy ameliorates the phenotype of PCOS model induced by letrozole

“…Polycystic ovary syndrome (PCOS) is a common endocrine disease that affects 6–21% women of reproductive age, approximately 75% of whom experience infertility due to anovulation [1,2]. Its pathological characteristics present diversity and heterogeneity, and include menstrual sparse or amenorrhea, chronic ovulation problem, infertility, increased hair growth, and acne, along with complications such as obesity, hyperandrogenism, hyperinsulinism, and chronic inflammation [3,4].…”

Manejo Terapêutico Da Infertilidade Em Mulheres Portadoras De Síndrome Do Ovário Policístico

“…19 O hormônio folículo estimulante (FSH) sérico nesta síndrome é muito baixo, com isso, gonadotrofinas exógenas podem ser administradas para aumentar seus níveis e estimular o crescimento folicular. 36 Como o FSH estimula o crescimento folicular ovariano, se a liberação de FSH diminui por um longo período, a maturação folicular e, subsequentemente, a ovulação não acontecem e ocorre subfertilidade. A secreção inadequada de gonadotrofinas é o principal atributo da SOP.…”