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Ovulation Induction Management of PCOS

GUZICK, DAVID S. MD, PhD

Clinical Obstetrics and Gynecology: March 2007 - Volume 50 - Issue 1 - p 255-267
doi: 10.1097/GRF.0b013e31802f361e
The Polycystic Ovary Syndrome

Ovulation induction is the principal infertility treatment for women with polycystic ovarian syndrome (PCOS). Among PCOS patients who are overweight or obese, weight loss is the most physiologic method of inducing ovulation. For women in whom weight loss is not possible, or for lean women with PCOS, clomiphene citrate is an effective first-line method of ovulation induction. In clomiphene-resistant women, alternative treatments include adjunctive metformin or dexamethasone, aromatase inhibitors, or ovarian drilling. If there is no pregnancy despite several cycles of successful ovulation induction, gonadotropin treatment should be considered, in which case in vitro fertilization is recommended as the safest and most effective strategy.

University of Rochester School of Medicine and Dentistry, Rochester, New York

Correspondence: David S. Guzick, MD, PhD, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 706, Rochester, NY 14642. E-mail: david_guzick@urmc.rochester.edu; janet_svendsen@urmc.rochester.edu

© 2007 Lippincott Williams & Wilkins, Inc.