Therapy choice - Therapy possibility in PCOS infertility patients
Ana Petko Mitrovic Jovanovic, Tomisla Jovanovic, Svetlana Dragojevic Dikic
Abstract
Background
Polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy of women of reproductive age. Infertility due to the PCOS is a complex and specific condition but the majority of the problem is the ovulatory dysfunction.
Aims
Evaluation of the therapy choice and reproductive therapy possibilities in PCOS infertility patients. Make it easier for clinicians.
Methods
Clinical experience based on review of the literature.
Results
The syndromes heterogeneity is reflected in the different response to the various ovulation inducting drugs. Management of anovulatory infertility associated with PCOS is based on the overall clinical picture. Lifestyle change programs, weight reduction diet and exercise, have been shown to be very effective in improving reproductive as well as metabolic characteristics of overweight and obese patients with PCOS. In women with anovulatory infertility, the first line of treatment for induction of ovulation is clomiphene citrate. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene therapy. Gonadotropin treatment is effective, but there is a risk of ovarian hyperstimulation syndrome. Surgery, such as laparoscopic ovarian drilling should be considered in some patients. Reconsider a use of metformin and supplements.
Conclusion
Understanding specific features and metabolic implications of different PCOS patients, may guide us to treat individuals optimally, as well as to develop effective prevention strategies to reduce the risk of long term complications- consequences and improve reproductive outcomes. Individual treatment modalities in PCOS patients are imperative for successful therapy.
Full Text:
Polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy of women of reproductive age. Infertility due to the PCOS is a complex and specific condition but the majority of the problem is the ovulatory dysfunction.
Aims
Evaluation of the therapy choice and reproductive therapy possibilities in PCOS infertility patients. Make it easier for clinicians.
Methods
Clinical experience based on review of the literature.
Results
The syndromes heterogeneity is reflected in the different response to the various ovulation inducting drugs. Management of anovulatory infertility associated with PCOS is based on the overall clinical picture. Lifestyle change programs, weight reduction diet and exercise, have been shown to be very effective in improving reproductive as well as metabolic characteristics of overweight and obese patients with PCOS. In women with anovulatory infertility, the first line of treatment for induction of ovulation is clomiphene citrate. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene therapy. Gonadotropin treatment is effective, but there is a risk of ovarian hyperstimulation syndrome. Surgery, such as laparoscopic ovarian drilling should be considered in some patients. Reconsider a use of metformin and supplements.
Conclusion
Understanding specific features and metabolic implications of different PCOS patients, may guide us to treat individuals optimally, as well as to develop effective prevention strategies to reduce the risk of long term complications- consequences and improve reproductive outcomes. Individual treatment modalities in PCOS patients are imperative for successful therapy.
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