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Human Reproduction Update, Vol.3, No.3 pp.235-253, 1997
© European Society of Human Reproduction and Embryology 1997; all rights reserved

Current and future status of ovulation induction in polycystic ovary syndrome

IE Messinisz and SD Milingos

Department of Obstetrics and Gynaecology, Medical School, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece z Corresponding author

Abstract

Great progress has been achieved during the last 20 years in the field of ovulation induction in patients with polycystic ovary syndrome (PCOS). Clomiphene citrate remains the first line of treatment for all anovulatory women with PCOS, since in properly selected patients the cumulative pregnancy rate approaches that in normal women. Human urinary gonadotrophins have been used extensively for ovulation induction but the development of low-dose regimens has opened a new era in the management of anovulation related to PCOS. This article discusses the main advantages and disadvantages of the principal methods and regimens currently used for ovulation induction in patients with PCOS including clomiphene citrate, gonadotrophins, pulsatile gonadotrophin-releasing hormone (GnRH) and GnRH agonists. It also discusses new drugs discovered recently, particularly recombinant gonadotrophins and GnRH antagonists, and provides some thoughts regarding their use in future protocols. Finally, based on the discovery of new ovarian substances which specifically control luteinizing hormone (LH) secretion, this article develops assumptions on possible implications of these substances in the pathophysiology of PCOS and their potential use in the management of the syndrome.

Keywords: clomiphene citrate/gonadotrophins/ovulation induction/polycystic ovary syndrome


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