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

Detalhes bibliográficos
Autor(a) principal: Melo, Anderson Sanches
Data de Publicação: 2015
Outros Autores: Ferriani, Rui Alberto, Navarro, Paula Andrea
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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spelling 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)
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instname_str Universidade de São Paulo (USP)
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reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
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