Ovulation induction: a mini review.
نویسنده
چکیده
Ovulation induction is the method for treating anovulatory infertility. For patients with hypogonadotrophic hypogonadism, the treatment involves administration of both FSH and LH, while HCG is injected for follicle rupture. Pulsatile GnRH has the same effectiveness as gonadotrophins and the advantage of the low multiple pregnancy rate. In polycystic ovary syndrome (PCOS), the first treatment choice is clomiphene citrate. With this drug, in properly selected patients, the cumulative pregnancy rate approaches that of normal women. Low-dose protocols of FSH are the second line of treatment, effective in inducing monofollicular development. Laparoscopic ovarian drilling can be an alternative but not as a first choice treatment in clomiphene-resistant patients. Other treatments, such as pulsatile GnRH and GnRH agonists, are hardly used today in PCOS. However, in obese women with PCOS, weight loss and exercise should be recommended as the first line of therapy. Newer agents including aromatase inhibitors and insulin sensitizers, although promising, need further evaluation.
منابع مشابه
Surgical Ovulation Induction in Women with Polycystic Ovary Syndrome: A Systematic Review
Background: Currently clomiphene citrate is the first-line treatment to induce ovulation in women with polycystic ovarian syndrome (PCOS). Surgical therapy with laparoscopic ovarian drilling (LOD) may avoid or reduce the need for gonadotropins. Objective: To determine the effectiveness and safety of LOD compared with ovulation induction in subfertile women with clomiphene-resistant PCOS. Search...
متن کاملI-35: Induction of Ovulation in Clomiphen Resistant
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which chronic anovulation is a common feature despite the presence of multiple micro- structures in the ovaries. A growing body of evidence has suggested that serum hyperinsulinemia and as the result hyperandrogenemia contributes to the excess ovarian androgen secretion observed in women with PCOS. The standard therapy for anovulat...
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BACKGROUND A recent meta-analysis has proven that metformin (M) is highly effective for ovulation induction in the clomiphene citrate (CC)-resistant patient. There is uncertainty whether M should be introduced as a primary ovulation induction agent in polycystic ovarian syndrome (PCOS). METHODS We conducted a systematic review and meta-analysis to establish if M is better when given alone or ...
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The polycystic ovary syndrome is the most common endocrinological disorder of reproductive age women with a prevalence of 5 to 8 %. The most common diagnostic criteria used for polycystic ovary syndrome are oligo- or an-ovulation, clinical and/ or biochemical signs of hyperandrogenism and polycystic ovaries. Hyperandrogenism results in increased estrogen levels and lack of cyclic progesterone d...
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CONTEXT For the last 40 yr, the first line of treatment for anovulation in infertile women has been clomiphene citrate (CC). CC is a safe, effective oral agent but is known to have relatively common antiestrogenic endometrial and cervical mucous side effects that could prevent pregnancy in the face of successful ovulation. In addition, there is a significant risk of multiple pregnancy with CC, ...
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ورودعنوان ژورنال:
- Human reproduction
دوره 20 10 شماره
صفحات -
تاریخ انتشار 2005