Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analysis methodology
PubMed 26602525 · doi:10.6061/clinics/2015(11)09
What was done
Narrative review outlining clinical approaches for anovulatory infertility in women with polycystic ovary syndrome (PCOS), detailing preconception guidelines, first- and second-line ovulation induction, and assisted reproductive technologies.
What was found
Polycystic ovary syndrome accounts for 80% of anovulatory infertility. First-line clomiphene citrate or second-line gonadotropin ovulation induction achieves cumulative live birth rates of approximately 70%. Laparoscopic ovarian drilling is effective in approximately 50% of cases when laparoscopy is indicated. In vitro fertilization or intracytoplasmic sperm injection serves as third-line treatment or as first-line for bilateral tubal occlusion or male factor infertility. The abstract notes no evidence for routine metformin use and states aromatase inhibitors require longer-term safety studies.
Why it matters
Provides a consolidated clinical overview of the stepwise escalation of fertility treatments for women with PCOS.
Limits
As a narrative review, it lacks a systematic search protocol, formal inclusion criteria, risk-of-bias assessments, and primary empirical data or confidence intervals.
Cited by
- contradicts Seventy to eighty percent of women with PCOS do not ovulate.
- context Between 70% and 80% of PCOS patients do not ovulate (anovulatory).