Ovulation Induction in Polycystic Ovary Syndrome: Current Options
Abstract There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-piuitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed towards repla...
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| Veröffentlicht in: | Best practice & research. Clinical obstetrics & gynaecology 2016-11, Vol.37, p.152-159 |
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| container_title | Best practice & research. Clinical obstetrics & gynaecology |
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| creator | Legro, Richard S., M.D |
| description | Abstract There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-piuitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed towards replacing clomiphene, a selective estrogen receptor modulator, as the first choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin), further study is needed of newer agents to treat type 2 diabetes. Weight loss interventions, both lifestyle related, through obesity drugs, or through bariatric surgery have shown mixed results on pregnancy outcomes. With both reproductive and metabolic treatments, combination therapies (such as metformin and clomiphene together) may offer greater benefit to distinct subgroups of patients. |
| doi_str_mv | 10.1016/j.bpobgyn.2016.08.001 |
| format | Article |
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The most effective treatments are primarily reproductive and target the hypothalamic-piuitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed towards replacing clomiphene, a selective estrogen receptor modulator, as the first choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin), further study is needed of newer agents to treat type 2 diabetes. Weight loss interventions, both lifestyle related, through obesity drugs, or through bariatric surgery have shown mixed results on pregnancy outcomes. With both reproductive and metabolic treatments, combination therapies (such as metformin and clomiphene together) may offer greater benefit to distinct subgroups of patients.</description><identifier>ISSN: 1521-6934</identifier><identifier>EISSN: 1532-1932</identifier><identifier>DOI: 10.1016/j.bpobgyn.2016.08.001</identifier><identifier>PMID: 27866938</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Anovulation - etiology ; Anovulation - therapy ; Anti-Obesity Agents - therapeutic use ; Aromatase Inhibitors - therapeutic use ; Bariatric Surgery ; clinical trials ; Clomiphene - therapeutic use ; Diet Therapy ; Exercise Therapy ; Female ; Fertility Agents, Female - therapeutic use ; Follicle Stimulating Hormone - therapeutic use ; Gonadotropin-Releasing Hormone - therapeutic use ; Humans ; hyperandrogenism ; Hypoglycemic Agents - therapeutic use ; infertility ; Infertility, Female - etiology ; Infertility, Female - therapy ; Inositol - therapeutic use ; Insulin Resistance ; Metformin - therapeutic use ; Nitriles - therapeutic use ; Obesity - complications ; Obesity - therapy ; Obstetrics and Gynecology ; Ovulation Induction - methods ; Polycystic Ovary Syndrome - complications ; Polycystic Ovary Syndrome - therapy ; Pregnancy ; Pregnancy Rate ; Selective Estrogen Receptor Modulators - therapeutic use ; Triazoles - therapeutic use</subject><ispartof>Best practice & research. 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Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-b29dd9cd421d9476b1387c20d99db6de39d943976a3e4995ad422458945a58b53</citedby><cites>FETCH-LOGICAL-c420t-b29dd9cd421d9476b1387c20d99db6de39d943976a3e4995ad422458945a58b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.bpobgyn.2016.08.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27866938$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Legro, Richard S., M.D</creatorcontrib><title>Ovulation Induction in Polycystic Ovary Syndrome: Current Options</title><title>Best practice & research. Clinical obstetrics & gynaecology</title><addtitle>Best Pract Res Clin Obstet Gynaecol</addtitle><description>Abstract There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-piuitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed towards replacing clomiphene, a selective estrogen receptor modulator, as the first choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin), further study is needed of newer agents to treat type 2 diabetes. Weight loss interventions, both lifestyle related, through obesity drugs, or through bariatric surgery have shown mixed results on pregnancy outcomes. With both reproductive and metabolic treatments, combination therapies (such as metformin and clomiphene together) may offer greater benefit to distinct subgroups of patients.</description><subject>Anovulation - etiology</subject><subject>Anovulation - therapy</subject><subject>Anti-Obesity Agents - therapeutic use</subject><subject>Aromatase Inhibitors - therapeutic use</subject><subject>Bariatric Surgery</subject><subject>clinical trials</subject><subject>Clomiphene - therapeutic use</subject><subject>Diet Therapy</subject><subject>Exercise Therapy</subject><subject>Female</subject><subject>Fertility Agents, Female - therapeutic use</subject><subject>Follicle Stimulating Hormone - therapeutic use</subject><subject>Gonadotropin-Releasing Hormone - therapeutic use</subject><subject>Humans</subject><subject>hyperandrogenism</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>infertility</subject><subject>Infertility, Female - etiology</subject><subject>Infertility, Female - therapy</subject><subject>Inositol - therapeutic use</subject><subject>Insulin Resistance</subject><subject>Metformin - therapeutic use</subject><subject>Nitriles - therapeutic use</subject><subject>Obesity - complications</subject><subject>Obesity - therapy</subject><subject>Obstetrics and Gynecology</subject><subject>Ovulation Induction - methods</subject><subject>Polycystic Ovary Syndrome - complications</subject><subject>Polycystic Ovary Syndrome - therapy</subject><subject>Pregnancy</subject><subject>Pregnancy Rate</subject><subject>Selective Estrogen Receptor Modulators - therapeutic use</subject><subject>Triazoles - therapeutic use</subject><issn>1521-6934</issn><issn>1532-1932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtr3DAQgEVIyav5CSk-5mJHb1s9tIQlaQMLW9jmLGxpErT1SlvJXvC_r5zd9pBLTxoN38ww3yB0Q3BFMJF3m6rbhe518hXN3wo3FcbkBF0QwWhJFKOnc0xJKRXj5-gypQ3GjCkqztA5rRuZ880Ful_tx74dXPDFk7ejeYucL36EfjJTGpwpVvs2TsV68jaGLXwuFmOM4IditZvh9BF9eGn7BNfH9wo9Pz78XHwvl6tvT4v7ZWk4xUPZUWWtMpZTYhWvZUdYUxuKrVK2kxaYymmmatky4EqJNpOUi0Zx0YqmE-wK3R767mL4PUIa9NYlA33feghj0qThVHAhBc-oOKAmhpQivOhddNu8hSZYz_b0Rh_t6dmexo3O9nLdp-OIsduC_Vf1V1cGvh4AyIvuHUSdjANvwLoIZtA2uP-O-PKug-mdd6btf8EEaRPG6LNFTXSiGuv1fML5gkQyjGsm2R8Q4Jdu</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Legro, Richard S., M.D</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161101</creationdate><title>Ovulation Induction in Polycystic Ovary Syndrome: Current Options</title><author>Legro, Richard S., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-b29dd9cd421d9476b1387c20d99db6de39d943976a3e4995ad422458945a58b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Anovulation - etiology</topic><topic>Anovulation - therapy</topic><topic>Anti-Obesity Agents - therapeutic use</topic><topic>Aromatase Inhibitors - therapeutic use</topic><topic>Bariatric Surgery</topic><topic>clinical trials</topic><topic>Clomiphene - therapeutic use</topic><topic>Diet Therapy</topic><topic>Exercise Therapy</topic><topic>Female</topic><topic>Fertility Agents, Female - therapeutic use</topic><topic>Follicle Stimulating Hormone - therapeutic use</topic><topic>Gonadotropin-Releasing Hormone - therapeutic use</topic><topic>Humans</topic><topic>hyperandrogenism</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>infertility</topic><topic>Infertility, Female - etiology</topic><topic>Infertility, Female - therapy</topic><topic>Inositol - therapeutic use</topic><topic>Insulin Resistance</topic><topic>Metformin - therapeutic use</topic><topic>Nitriles - therapeutic use</topic><topic>Obesity - complications</topic><topic>Obesity - therapy</topic><topic>Obstetrics and Gynecology</topic><topic>Ovulation Induction - methods</topic><topic>Polycystic Ovary Syndrome - complications</topic><topic>Polycystic Ovary Syndrome - therapy</topic><topic>Pregnancy</topic><topic>Pregnancy Rate</topic><topic>Selective Estrogen Receptor Modulators - therapeutic use</topic><topic>Triazoles - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Legro, Richard S., M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Best practice & research. 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Letrozole, an aromatase inhibitor, is headed towards replacing clomiphene, a selective estrogen receptor modulator, as the first choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin), further study is needed of newer agents to treat type 2 diabetes. Weight loss interventions, both lifestyle related, through obesity drugs, or through bariatric surgery have shown mixed results on pregnancy outcomes. With both reproductive and metabolic treatments, combination therapies (such as metformin and clomiphene together) may offer greater benefit to distinct subgroups of patients.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>27866938</pmid><doi>10.1016/j.bpobgyn.2016.08.001</doi><tpages>8</tpages></addata></record> |
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| ispartof | Best practice & research. Clinical obstetrics & gynaecology, 2016-11, Vol.37, p.152-159 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Anovulation - etiology Anovulation - therapy Anti-Obesity Agents - therapeutic use Aromatase Inhibitors - therapeutic use Bariatric Surgery clinical trials Clomiphene - therapeutic use Diet Therapy Exercise Therapy Female Fertility Agents, Female - therapeutic use Follicle Stimulating Hormone - therapeutic use Gonadotropin-Releasing Hormone - therapeutic use Humans hyperandrogenism Hypoglycemic Agents - therapeutic use infertility Infertility, Female - etiology Infertility, Female - therapy Inositol - therapeutic use Insulin Resistance Metformin - therapeutic use Nitriles - therapeutic use Obesity - complications Obesity - therapy Obstetrics and Gynecology Ovulation Induction - methods Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - therapy Pregnancy Pregnancy Rate Selective Estrogen Receptor Modulators - therapeutic use Triazoles - therapeutic use |
| title | Ovulation Induction in Polycystic Ovary Syndrome: Current Options |
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