Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/107685 |
Resumo: | 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. |
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Clinics |
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Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice 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. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2015-11-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/10768510.6061/clinics/2015(11)09Clinics; Vol. 70 No. 11 (2015); 765-769Clinics; v. 70 n. 11 (2015); 765-769Clinics; Vol. 70 Núm. 11 (2015); 765-7691980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/107685/106065Copyright (c) 2015 Clinicsinfo:eu-repo/semantics/openAccessMelo, Anderson SanchesFerriani, Rui AlbertoNavarro, Paula Andrea2015-11-24T12:09:34Zoai:revistas.usp.br:article/107685Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2015-11-24T12:09:34Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
title |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
spellingShingle |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice Melo, Anderson Sanches |
title_short |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
title_full |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
title_fullStr |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
title_full_unstemmed |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
title_sort |
Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice |
author |
Melo, Anderson Sanches |
author_facet |
Melo, Anderson Sanches Ferriani, Rui Alberto Navarro, Paula Andrea |
author_role |
author |
author2 |
Ferriani, Rui Alberto Navarro, Paula Andrea |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Melo, Anderson Sanches Ferriani, Rui Alberto Navarro, Paula Andrea |
description |
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. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-11-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/107685 10.6061/clinics/2015(11)09 |
url |
https://www.revistas.usp.br/clinics/article/view/107685 |
identifier_str_mv |
10.6061/clinics/2015(11)09 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/107685/106065 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2015 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2015 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 70 No. 11 (2015); 765-769 Clinics; v. 70 n. 11 (2015); 765-769 Clinics; Vol. 70 Núm. 11 (2015); 765-769 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222762257612800 |