Reproductive impact of polycystic ovary syndrome

Rebecca S. Usadi, Richard Legro

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: The purpose of this review is to highlight the impact of polycystic ovary syndrome (PCOS) on menstrual function, fertility and reproductive outcomes. Women with PCOS often present with anovulation, menstrual disturbances and hyperandrogenism. Management options for the reproductive disorders of PCOS will be discussed. RECENT FINDINGS: The role of metformin in treating PCOS is narrowing. New data show improved live birth rates by skipping a progestin withdrawal bleed and proceeding directly with a dose escalation of clomiphene for ovulation induction. The Pregnancy in PCOS trial II will determine the safety and efficacy of clomiphene citrate compared to letrozole, in achieving live birth in infertile women with PCOS. SUMMARY: Initial treatment for reproductive disorders in overweight and obese women with PCOS is weight loss. This helps menstrual disturbances, shortens the time to conception and reduces adverse obstetric risks. Clomiphene citrate is considered the first-line therapy for ovulatory infertility. Clomiphene citrate-resistant women may be offered aromatase inhibitors or laparoscopic ovarian surgery. Metformin does not improve live birth rate or reduce miscarriage rate and is no longer considered an option for ovulation induction. Women with PCOS need to be counseled about risks of multiple gestations with gonadotropin therapy.

Original languageEnglish (US)
Pages (from-to)505-511
Number of pages7
JournalCurrent Opinion in Endocrinology, Diabetes and Obesity
Volume19
Issue number6
DOIs
StatePublished - Dec 1 2012

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Polycystic Ovary Syndrome
Clomiphene
Live Birth
letrozole
Ovulation Induction
Birth Rate
Metformin
Anovulation
Hyperandrogenism
Pregnancy
Aromatase Inhibitors
Spontaneous Abortion
Progestins
Gonadotropins
Laparoscopy
Infertility
Obstetrics
Fertility
Weight Loss
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

Cite this

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Reproductive impact of polycystic ovary syndrome. / Usadi, Rebecca S.; Legro, Richard.

In: Current Opinion in Endocrinology, Diabetes and Obesity, Vol. 19, No. 6, 01.12.2012, p. 505-511.

Research output: Contribution to journalReview article

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