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Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice

Melo, Anderson Sanches ; Ferriani, Rui Alberto ; Navarro, Paula Andrea

Clinics (São Paulo, Brazil), 2015-11, Vol.70 (11), p.765-769 [Periódico revisado por pares]

Brazil: Elsevier España, S.L.U

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  • Título:
    Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice
  • Autor: Melo, Anderson Sanches ; Ferriani, Rui Alberto ; Navarro, Paula Andrea
  • Assuntos: Clomiphene - therapeutic use ; Clomiphene Citrate ; Female ; Fertility Agents, Female - therapeutic use ; Fertilization in Vitro - methods ; Gonadotropins - therapeutic use ; Humans ; In Vitro Fertilization ; Infertility ; Infertility, Female - therapy ; Laparoscopy - methods ; Life Style ; MEDICINE, GENERAL & INTERNAL ; Ovarian Drilling ; Polycystic Ovary Syndrome ; Polycystic Ovary Syndrome - complications ; Pregnancy ; Review
  • É parte de: Clinics (São Paulo, Brazil), 2015-11, Vol.70 (11), p.765-769
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    Melo AS reviewed the literature and wrote the manuscript. Navarro PA coordinated the study and conducted a systematic review of the manuscript. Ferriani RA conducted a systematic review of the manuscript and reviewed the literature.
  • Descrição: Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss), folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling). Ovulation induction using clomiphene citrate or gonadotropins is effective with cumulative live birth rates of approximately 70%. Ovarian drilling should be performed when laparoscopy is indicated; this procedure is typically effective in approximately 50% of cases. Finally, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection) is the third-line treatment and is recommended when the previous interventions fail. This option is also the first choice in cases of bilateral tubal occlusion or semen alterations that impair the occurrence of natural pregnancy. Evidence for the routine use of metformin in infertility treatment of anovulatory women with polycystic ovary syndrome is not available. Aromatase inhibitors are promising and longer term studies are necessary to prove their safety.
  • Editor: Brazil: Elsevier España, S.L.U
  • Idioma: Inglês;Português
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