Okoroafor Ugochi C, Jungheim Emily S
Department of Obstetrics and Gynecology, Washington University, St Louis, MO, USA.
Patient Prefer Adherence. 2012;6:407-15. doi: 10.2147/PPA.S25286. Epub 2012 May 24.
Polycystic ovary syndrome (PCOS) is a heterogeneous condition characterized by anovulation, hyperandrogenism, and polycystic ovaries. Because of the heterogeneous nature of PCOS, women affected by the condition often require a customized approach for ovulation induction when trying to conceive. Treating symptoms of PCOS in overweight and obese women should always incorporate lifestyle changes with the goal of weight-loss, as many women with PCOS will ovulate after losing 5%-10% of their body weight. On the other hand, other factors must be considered including the woman's age, age-related decline in fertility, and previous treatments she may have already tried. Fortunately, multiple options for ovulation induction exist for women with PCOS. This paper reviews specific ovulation induction options available for women with PCOS, the benefits and efficacy of these options, and the related side effects and risks women can anticipate with the various options that may affect treatment adherence. The paper also reviews the recommended evidence-based strategies for treating PCOS-related infertility that allow for incorporation of the patient's preference. Finally, it briefly reviews emerging data and ongoing studies regarding newer agents that have shown great promise as first-line agents for the treatment of infertility in women with PCOS.
多囊卵巢综合征(PCOS)是一种异质性疾病,其特征为无排卵、高雄激素血症和多囊卵巢。由于PCOS的异质性,受该疾病影响的女性在尝试受孕时通常需要采用定制的促排卵方法。对于超重和肥胖的PCOS女性,治疗其症状应始终将生活方式改变与减肥目标相结合,因为许多PCOS女性在体重减轻5%-10%后会恢复排卵。另一方面,还必须考虑其他因素,包括女性的年龄、与年龄相关的生育能力下降以及她可能已经尝试过的先前治疗方法。幸运的是,PCOS女性有多种促排卵选择。本文综述了PCOS女性可用的特定促排卵选择、这些选择的益处和疗效,以及女性在各种可能影响治疗依从性的选择中可能预期的相关副作用和风险。本文还综述了用于治疗PCOS相关不孕症的推荐循证策略,这些策略允许纳入患者的偏好。最后,简要回顾了有关新型药物的新数据和正在进行的研究,这些药物作为治疗PCOS女性不孕症的一线药物显示出巨大潜力。