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Acta Obstet Gynecol Scand ; 97(10): 1162-1167, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29889977

RESUMO

The objective of this narrative review was to suggest a rational order of treatment choices in anovulatory women with polycystic ovary syndrome (PCOS), for whom a multitude of treatment options exist. In obese/overweight women with PCOS the importance of weight reduction should be stressed. Inositol, a dietary supplement with a documented effect on ovulation and without adverse effects in the doses recommended, may be suggested. Additional first-line medical alternatives include insulin sensitizers, selective estrogen receptor modulators, and aromatase inhibitors. Of these, the aromatase inhibitor letrozole and the combination of clomiphene citrate and metformin have the highest rates of ovulation and live birth. Second-line treatments are ovarian electrocautery and low-dose follicle-stimulating hormone stimulation. Controlled ovarian stimulation with in vitro fertilization, should be considered the last option as it carries a significant risk of ovarian hyperstimulation syndrome in patients with PCOS.


Assuntos
Infertilidade Feminina/prevenção & controle , Indução da Ovulação/métodos , Síndrome do Ovário Policístico/terapia , Feminino , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Síndrome de Hiperestimulação Ovariana/prevenção & controle , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
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