No. 362-Ovulation Induction in Polycystic Ovary Syndrome

Area of Science:

• Reproductive Endocrinology and Infertility
• Women's Health
• Metabolic Disorders

Background:

• Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder associated with infertility.
• Ovulation induction is a key component in managing PCOS-related infertility.
• Current guidelines require review to reflect the latest evidence in PCOS management.

Purpose of the Study:

• To review current non-pharmacologic and pharmacologic options for ovulation induction in women diagnosed with PCOS.
• To evaluate the efficacy and safety of various treatment modalities for PCOS infertility.

Main Methods:

• A comprehensive literature search was conducted using Medline and other databases for studies published between 2000 and 2016.
• Included were systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies.
• Evidence was evaluated by the Society of Obstetricians and Gynaecologists of Canada's Reproductive Endocrinology and Infertility Committee.

Main Results:

• Weight reduction and exercise improve ovulation, pregnancy, and live birth rates in women with PCOS.
• Aromatase inhibitors and selective estrogen receptor modulators are effective first-line medical therapies for ovulation induction.
• Potential harms include medication side effects and an increased risk of multiple pregnancies.

Conclusions:

• First-line management for PCOS infertility includes lifestyle modifications such as weight loss and exercise.
• Aromatase inhibitors and selective estrogen receptor modulators are recommended as initial pharmacologic treatments for ovulation induction.
• Insulin sensitizers should be used as adjuncts, and gonadotropins or in vitro fertilization (IVF) should be considered for refractory cases.