What are the most appropriate treatments for patients with Polycystic Ovary Syndrome (PCO) who desire fertility?
- Well ASRM and ESHRE had a consensus meeting last year and here is the abstract (most important points highlighted in bold by me):
Consensus on infertility treatment related to polycystic ovary syndrome.
The treatment of infertile women with polycystic ovary syndrome (PCOS) is surrounded by many controversies. On the basis of the currently available evidence, a group of experts reached a consensus regarding the therapeutic challenges raised in these women. Before any intervention is initiated, preconceptional counseling should be provided emphasizing the importance of lifestyle, especially weight reduction and exercise in overweight women, smoking, and alcohol consumption. The recommended first-line treatment for ovulation induction remains the anti-estrogen clomiphene citrate (CC). Recommended second-line intervention, should CC fail to result in pregnancy, is either exogenous gonadotropins or laparoscopic ovarian surgery (LOS). The use of exogenous gonadotropins is associated with increased chances for multiple pregnancy, and, therefore, intense monitoring of ovarian response is required. Laparoscopic ovarian surgery alone is usually effective in less than 50% of women, and additional ovulation induction medication is required under those circumstances. Overall, ovulation induction (representing the CC-gonadotropin paradigm) is reported to be highly effective with a cumulative singleton live-birth rate of 72%. Recommended third-line treatment is in vitro fertilization (IVF). More patient-tailored approaches should be developed for ovulation induction based on initial screening characteristics of women with PCOS. Such approaches may result in deviation from the above mentioned first-line, second-line, or third-line ovulation strategies in well-defined subsets of patients. Metformin use in PCOS should be restricted to women with glucose intolerance. Based on recent data available in the literature, the routine use of this drug in ovulation induction is not recommended. Insufficient evidence is currently available to recommend the clinical use of aromatase inhibitors for routine ovulation induction. Even singleton pregnancies in PCOS are associated with increased health risk for both the mother and the fetus.
- Source : Fertility And Sterility via MEDLINE
Blog dedicated to daily infertility news with comments from Andrea Vidali MD , Reproductive Endocrinologist in New York.
Contact Dr. Vidali
Click on any topic for articles!
ivf
clomid
diminished ovarian reserve
amh
day 3 fsh
ivf explanation
sperm
clomifene
habitual abortion
infertility
male infertility
miscarriage
"ivf success rates"
Age and fertility
alternative medicine
fsh
ivf failure
pcos
progesterone
"fertility and the environment"
Age
Antimullerian Hormone
IVF success rates
Religion
acupuncture
amh levels
autism
embryo transfer
ene
femara
fertility
fertility test
in vitro fertilization
iui
iui success rates
ivf baby
ivf birth defects
nutrition
polycystic ovaries
stress and fertility
"IVF cost"
Clinic Statistics
DHEA
Ectopic Pregnancy
Fertile period
Tubal Disease
basal body temperature
birth defects
blastocyst
caffeine
clomid success rates
cystic fibrosis
early menopause
endometrial thickness
environment
failed ivf
fertility risk factors
fetal demise
fetal heart rate
fetal ultrasound
genetics
glucophage
hMG
icsi birth defects
immunology
insemination
ivf success rate
lifestyle and
luteal phase
metformin
ohss
ovulation induction
philosopical issues in medicine
pregnancy rates
premature ovarian failure
reproductive immunology
serophene
sperm donation
sperm donor
tdi
Wednesday, February 06, 2008
Labels:
clomid,
clomifene,
ene,
ovulation induction,
pcos,
polycystic ovaries
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment