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Ovulation induction in normogonadotropic anovulation (PCOS)

Authors
Journal
Best Practice & Research Clinical Endocrinology & Metabolism
1521-690X
Publisher
Elsevier
Publication Date
Volume
20
Issue
2
Identifiers
DOI: 10.1016/j.beem.2006.03.002
Keywords
  • Ovulation Induction
  • Pcos
  • Fsh
  • Clomiphene Citrate
Disciplines
  • Computer Science

Abstract

Treatment of normogonadotropic anovulatory infertility (World Health Organization class 2, or WHO2) is by induction of ovulation using clomiphene citrate (CC), followed by follicle-stimulating hormone (FSH) in cases of treatment failure. Not all patients will become ovulatory or will conceive with this treatment. Others, exhibiting multifollicular instead of monofollicular development, may encounter complications such as ovarian hyperstimulation and multiple pregnancy. Recently introduced alternative treatment interventions—such as insulin-sensitizing drugs, aromatase inhibitors, or laparoscopic electrocautery of the ovaries—may offer the possibility of improving the efficacy of the classical ovulation induction algorithm. Based on initial patient characteristics, it may be possible to identify specific patient subgroups with altered chances of success or complications while using one of these interventions. Regarding CC and FSH ovulation induction, this has been performed using multivariate prediction models. This approach may enable us to improve safety, cost-effectiveness, and patient convenience in future ovulation induction.

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