Guzick David S
University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Clin Obstet Gynecol. 2007 Mar;50(1):255-67. doi: 10.1097/GRF.0b013e31802f361e.
Ovulation induction is the principal infertility treatment for women with polycystic ovarian syndrome (PCOS). Among PCOS patients who are overweight or obese, weight loss is the most physiologic method of inducing ovulation. For women in whom weight loss is not possible, or for lean women with PCOS, clomiphene citrate is an effective first-line method of ovulation induction. In clomiphene-resistant women, alternative treatments include adjunctive metformin or dexamethasone, aromatase inhibitors, or ovarian drilling. If there is no pregnancy despite several cycles of successful ovulation induction, gonadotropin treatment should be considered, in which case in vitro fertilization is recommended as the safest and most effective strategy.
促排卵是多囊卵巢综合征（PCOS）女性主要的不孕症治疗方法。在超重或肥胖的PCOS患者中，减重是诱导排卵最符合生理的方法。对于无法减重的女性或体型偏瘦的PCOS女性，枸橼酸氯米芬是一种有效的一线促排卵方法。对于氯米芬抵抗的女性，替代治疗包括辅助使用二甲双胍或地塞米松、芳香化酶抑制剂或卵巢打孔术。如果经过几个周期成功的促排卵仍未怀孕，则应考虑使用促性腺激素治疗，在这种情况下，建议将体外受精作为最安全、最有效的策略。
