Ovulation induction in anovulatory infertility is obsolete

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment

Background:

• Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility.
• Ovulation induction for timed intercourse is the standard first-line treatment.

Purpose of the Study:

• To evaluate the efficacy and safety of individualized IVF versus ovarian induction for anovulatory infertility.
• To challenge the established first-line treatment approach for anovulatory infertility.

Main Methods:

• Review of prospective studies on ovulation induction.
• Analysis of cumulative pregnancy rates and risks associated with ovarian induction.
• Comparison with outcomes of individualized IVF, including cycle segmentation and single-embryo transfer.

Main Results:

• Ovulation induction achieved cumulative singleton live-birth rates of 71-78% over 2 years but carries risks of multiple pregnancies.
• Individualized IVF offers cumulative pregnancy rates of 83% over three cycles with significantly reduced multiple pregnancy risk.
• IVF minimizes medication exposure and time to pregnancy compared to prolonged ovarian induction.

Conclusions:

• Individualized IVF provides a safer and potentially more efficient alternative to ovarian induction for anovulatory infertility.
• The risks and limitations of ovarian induction warrant a re-evaluation of its role as a first-line therapy.
• The advancement of IVF techniques challenges the traditional approach to treating anovulatory infertility.