Hart Roger
Fertility Specialists of Western Australia, UWA School of Women's and Infants' Health, University of Western Australia, King Edward Memorial Hospital, Subiaco, Perth, Western Australia, Australia.
Curr Opin Obstet Gynecol. 2007 Dec;19(6):529-35. doi: 10.1097/GCO.0b013e3282f10e22.
Polycystic ovarian syndrome is the commonest endocrine disorder of reproductive-age women. It may have implications for women with regard to anovulatory infertility, insulin resistance and elevated androgens. Furthermore, patients are prone to health problems in later life, including diabetes and cardiovascular risk. This review provides an update of recent findings for the management of polycystic ovarian syndrome.
Studies have been performed to determine the best first-line medication for ovulation induction in polycystic ovarian syndrome. Meta-analyses have been performed to determine whether metformin should be used as an adjunct in IVF in women with this syndrome and to determine whether metformin or the oral contraceptive pill should be used for symptom control. Adverse features of this syndrome can be improved by diet and exercise. Evidence for the longer-term use of metformin to protect against adverse cardiovascular outcomes, and for its pregnancy use to reduce gestational diabetes, preeclampsia, and fetal macrosomia is lacking, although evidence for a reduction in miscarriage in insulin-resistant patients is accumulating.
Recent studies have sought to clarify the serious short-term clinical problems faced by women with polycystic ovarian syndrome; however, studies looking to the long term to address cardiovascular and diabetic conversion are still required.
多囊卵巢综合征是育龄女性最常见的内分泌紊乱疾病。它可能会给女性带来无排卵性不孕、胰岛素抵抗和雄激素水平升高等问题。此外，患者在晚年容易出现健康问题，包括糖尿病和心血管疾病风险。本综述提供了多囊卵巢综合征治疗方面最新研究结果的更新。
已开展多项研究以确定多囊卵巢综合征促排卵的最佳一线用药。已进行荟萃分析，以确定二甲双胍是否应作为该综合征女性体外受精的辅助用药，以及确定二甲双胍或口服避孕药是否应用于症状控制。该综合征的不良特征可通过饮食和运动得到改善。尽管胰岛素抵抗患者流产率降低的证据在不断积累，但缺乏长期使用二甲双胍预防不良心血管结局以及孕期使用二甲双胍降低妊娠期糖尿病、先兆子痫和巨大儿发生率的证据。
近期研究试图阐明多囊卵巢综合征女性面临的严重短期临床问题；然而，仍需要开展着眼于长期解决心血管疾病和糖尿病转化问题的研究。
