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Evidence Based Management of Infertility in Women with Polycystic Ovarian Disease

Garima Kachhawa , Garima Kachhawa , Nutan Agarwal

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Indian Journal of Obstetrics and Gynecology 1(1):p 13-19, January - June 2013. | DOI:

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Abstract

PCOS is the most common cause of anovulatory infertility. Life style changes is the first line treatment in management of PCOS. Even 5-10% weight loss has significant clinical benefits. Obesity is associated even with long-term metabolic outcome in children. Weight loss should be advised prior to conception. First choice of ovulation induction is clomiphene citrate (CC) use of metformin in PCOS should be restricted to the patients with glucose intolerance. Gonadotrophin with starting dose of 37.5-50 IU/day should be used in CC failure situation. Laparoscopic ovarian surgery (LOS) s preferred in CC resistant cases with persistently hypersecretion of LH. It can be alternative to gonadotrophin for CC resistant PCOS cases. Repeated LOS should not be encouraged. In >50% of LOS treated adjuvant treatment may be required. Addition therapy with CC can be instituted after 12 weeks and gonadotrophines may be considered after 6 weeks. After failure of all modalities IVF may be offered.  

Key words: Infertility; Induction of ovulation. 

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