Ovulation induction in polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common reason of anovulatory infertility in reproductive age women. To make ovulation in these patients, from simple approach like life style changes to complicated therapies like assisted reproductive techniques are used. In this review, we aimed to emphasize different ovulation induction techniques that can be used in cases with PCOS. J Clin Exp Invest 2014; 5 (4): 626-631

Keywords

• Polycystic ovary syndrome, anovulation, infertility, ovulation induction

Polikistik over sendromunda ovulasyon indüksiyonu

Öz

Polikistik over sendromu (PKOS), üreme çağındaki kadınlarda en sık anovulatuvar infertilite nedenidir. Bu olgularda ovulasyonu sağlama amaçlı yaşam tarzı değişikliği gibi basit yaklaşımlardan ve yardımcı üreme teknikleri gibi komplike tedavilere kadar değişik yaklaşımlar uygulanmaktadır. Bu derlemede amacımız, PKOS olgularında kullanılabilen değişik ovulasyon indüksiyonu yöntemlerinin irdelenmesidir.

Anahtar Kelimeler

• Polikistik over sendromu, anovulasyon, infertilite, ovulasyon indüksiyonu

Kaynakça

1. Franks S. Polycystic ovary syndrome. N Engl J Med 1995;333:853-861.
2. Stein IF, Leventhal ML. Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935;29:181-191.
3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consen- sus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81:19- 25.
4. Huang A, Brennan K, Azziz R. Prevalence of hyperandr- ogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria. Fertil Steril 2010;93:1938-1941.
5. Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab 1980;50:113- 116.
6. Willis D, Franks S. Insulin action in human granulosa cells from normal and polycystic ovaries is mediated by the insulin receptor and not the type-I insulin-like growth factor receptor. J Clin Endocrinol Metab 1995;80:3788- 3790.
7. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogen- esis. Endocrine Rev 1997;18:774e800.
8. Franks S, Mason H & Willis D. Follicular dynamics in the polycystic ovary syndrome. Mol Cell Endocrinol 2000;163: 49e52.

9. Butzow TL, Moilanen JM, Lehtovirta M, et al. Serum and follicular fluid leptin during in vitro fertilization: re- lationship among leptin increase, body fat mass, and reduced ovarian response. J Clin Endocrinol Metab 1999;84:3135–3139.
10. Alebić MS, Bulum T, Stojanović N, Duvnjak L. Defini- tion of insulin resistance using the homeostasis model assessment (HOMA-IR) in IVF patients diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria. Endocrine 2014 [Epub ahead of print].
11. Kashar-Miller M, Azziz R. Heritability and the risk of de- veloping androgen excess. J Steroid Biochem Mol Biol 1999;69:261-268.
12. NN Joe-kechebelu, SU Mbamara, JI Ikechebelu. Famil- ial trend in polycystic ovarian syndrome: Report of two cases. Ann Afr Med 2013;12:182-184.
13. Livadas S, Diamanti-Kandarakis E. Polycystic ovary syndrome: definitions, phenotypes and diagnostic ap- proach. Front Horm Res 2013;40:1-21.
14. “BMI classification”. World Health Organization. Re- trieved 15 February 2014.
15. Gambineri A, Pelusi C, Vicennati V, et al. Obesity and the polycystic ovary syndrome. International Journal of Obesity & Related Metabolic Disorders 2002; 26: 883e896.
16. Yildiz BO, Knochenhauer ES, Azziz R. Impact of obe- sity on the risk for polycystic ovary syndrome. J Clin Endocrinol Metab 2008; 93:162-168.
17. Frary JM, Bjerre KP, Glintborg D, Ravn P. The effect of dietary carbohydrates in women with polycystic ovary syndrome. Minerva Endocrinol 2014 [Epub ahead of print].
18. Patel SM, Nestler JE. Fertility in polycystic ovary syn- drome. Endocrinol Metab Clin North Am 2006;35:137- 155.
19. Thessaloniki EA-SPCWG. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril 2008; 89: 505-522.
20. Legro RS, Chiu P, Kunselman AR, et al. Polycystic ovaries are common in women with hyperandrogenic chronic anovulation but do not predict metabolic or reproductive phenotype. J Clin Endocrinol Metab 2005;90:2571–2579.
21. Legro RS. Obesity and PCOS: implications for diag- nosis and treatment. Semin Reprod Med 2012;30:496- 506.
22. Clark AM, Thornley B, Tomlinson L, et al. Weight loss in obese infertile women results in improvement in re- productive outcome for all forms of fertility treatment. Human Reproduction 1998; 13: 1502e -1505.
23. Hart R, Norman R. Polycystic ovarian syndrome--prog- nosis and outcomes. Best Pract Res Clin Obstet Gyn- aecol 2006;20:751-778.
24. Perales-Puchalt A, Legro RS. Ovulation induction in women with polycystic ovary syndrome. Steroids 2013;78:767-772.
25. Lim SS, Norman RJ, Davies MJ, Moran LJ. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev 2013;14:95-109.
26. Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg 2009;19:1605-1611.
27. Baillargeon JP, Jakubowicz DJ, Iuorno MJ, et al. Effects of metformin and rosiglitazone, alone and in combina- tion, in non-obese women with polycystic ovary syn- drome and normal indices of insulin sensitivity. Fertil Steril 2004;82:893-902.
28. Carmina E, Lobo RA. Does metformin induce ovulation in normoandrogenic anovulatory women? Am J Obstet Gynecol 2004;191:15801584.
29. Tang T, Lord JM, Norman RJ, et al. Insulin-sensitizing drugs (metformin, rosiglitazone, pioglitazone, D-chiro- inositol) for women with polycystic ovary syndrome, oli- go-amenorrhoea and subfertility. Cochrane Database Syst Rev 2012;5:CD003053.
30. Legro RS, Barnhart HX, Schlaff WD, et al. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med 2007;356:551-556.
31. A Ayaz, Y Alwan, and MU Farooq. Efficacy of combined metformin–clomiphene citrate in comparison with clo- miphene citrate alone in infertile women with polycystic ovarian syndrome (PCOS). J Med Life 2013;6:199-201.
32. Neveu N, Granger L, St-Michel P, Lavoie HB. Com- parison of clomiphene citrate, metformin, or the com- bination of both for first-line ovulation induction and achievement of pregnancy in 154 women with polycys- tic ovary syndrome. Fertil Steril 2007 ;87:113-120.
33. Ota H, Goto T, Yoshioka T, Ohyama N. Success- ful pregnancies treated with pioglitazone in infertile patients with polycystic ovary syndrome. Fertil Steril 2008;90:709-713.
34. Ma LK, Jin LN, Yu Q, Xu L. Effect of lifestyle adjust- ment, metformin and rosiglitazone in polycystic ovary syndrome. Zhonghua Fu Chan Ke Za Zhi 2007;42:294- 297.
35. Rouzi AA, Ardawi MS. A randomized controlled trial of the efficacy of rosiglitazone and clomiphene citrate versus metformin and clomiphene citrate in women with clomiphene citrate-resistant polycystic ovary syn- drome. Fertil Steril 2006;85:428-435.
36. Zhang CL, Gao HY, Zhao ZG, Jia P. Effect of rosigli- tazone on ovulation induction in women with polycys- tic ovary syndrome. Zhonghua Fu Chan Ke Za Zhi 2004;39:173-175.
37. Messinis IE. Ovulation induction: a mini review. Hum Reprod 2005; 20: 2688e2697.
38. Clark JH, Markaverich BM. The agonist-antag- onist properties of clomiphene. Pharmacol Ther 1981;15:467-519.
39. Hammod MG, Halme JK, Talbert LM. Factors effecting pregnancy rate in clomiphene citrate induction of ovula- tion. Obstet Gynecol 1983;62:196–202.
40. Kalra A, Nair S, Rai L. Association of obesity and insulin resistance with dyslipidemia in Indian women with poly- cystic ovarian syndrome. Indian J Med Sci 2006;60:44- 53.
41. MacDougall MJ, Tan SL, Hall V, et al. Comparison of natural with clomiphene citrate-stimulated cycles in in vitro fertilization: a prospective, randomized trial. Fertil Steril 1994;61:1052-1057.
42. Asch RH, Greenblatt RB. Update on the safety and ef- ficacy of clomiphene citrate as a therapeutic agent. J Reprod Med 1976;17:175-180.
43. Rossing MA, Daling JR, Weiss NS, et al. Ovarian tumors in a cohort of infertile women. N Engl J Med 1994;331:771-776.
44. Mitwally MF, Casper RF. Single-dose administration of an aromatase inhibitor for ovarian stimulation. Fertil Steril 2005; 83: 229e231.
45. Casper RF, Mitwally MF. Use of the aromatase in- hibitor letrozole for ovulation induction in women with polycystic ovarian syndrome. Clin Obstet Gynecol 2011;54:685-695.
46. Holzer H, Casper R, Tulandi T. A new era in ovulation induction. Fertil Steril 2006;85:277-284.
47. Casper RF, Mitwally MF. Use of the aromatase in- hibitor letrozole for ovulation induction in women with polycystic ovarian syndrome. Clin Obstet Gynecol 2011;54:685-695.
48. Misso ML, Wong JL, Teede HJ, et al. Aromatase inhibi- tors for PCOS: a systematic review and meta-analysis. Hum Reprod Update 2012;18:301-312.
49. Nugent D, Vandekerckhove P, Hughes E, et al. Gonad- otrophin therapy for ovulation induction in subfertility kjassociated with polycystic ovary syndrome. Cochrane Database of Systematic Reviews 2000; 4: CD000410.
50. Christin-Maitre S, Hugues JN. A comparative random- ized multicentric study comparing the step-up versus step-down protocol in polycystic ovary syndrome. Hum Reprod 2003;18:1626-1631.
51. Homburg R, Hendriks ML, König TE, et al. Clomifene citrate or low-dose FSH for the first-line treatment of infertile women with anovulation associated with poly- cystic ovary syndrome: A prospective randomized mul- tinational study. Hum Reprod 2012;27:468-473.
52. Stein IF, Cohen MR, Elson R. Results of bilateral ovar- ian wedge resevtion in 47 cases of sterility; 20 year end results; 75 cases of bilateral polycystic ovaries. Am J Obstet Gynecol 1949;58:267-274.
53. Badawy A, Khiary M, Ragab A, et al. Ultrasound-guided transvaginal ovarian needle drilling (UTND) for treat- ment of polycystic ovary syndrome: A randomized con- trolled trial. Fertil Steril 2009; 91:1164-1167.
54. Zhu WJ, Fu ZH, Chen XM, et al. Ultrasound-guided transvaginal ovarian interstitial laser treatment in patients with polycystic ovary syndrome: A laser dose-finding study. Zhonghua Fu Chan Ke Za Zhi 2009;44:27-31.
55. Braidy C, Nazac A, Legendre G, et al. Comparison of fertiloscopy versus laparoscopy in the exploration of the infertility: Analysis of the literature. J Gynecol Ob- stet Biol Reprod 2014; pii: S0368-2315(14)00085-4.
56. R Homburg. Laparoscopic Ovarian Drilling. Ovulation Induction and Controlled Ovarian Stimulation, 2nd edi- tion, Springer 2014;XI:1-2.
57. Farguhar C, Lilford RJ, Marjoribanks J, Vandekerck- hove P. Laparoscopic ‘drilling’ by diathermy or la- ser for ovulation induction in anovulatory polycys- tic ovary syndrome. Cochrane Databsae Syst Rev 2007;3:CD001122.
58. Roy KK, Baruah J, Sharma A, et al. A prospective ran- domized trial comparing the clinical and endocrino- logical outcome with rosiglitazone versus laparoscopic ovarian drilling in patients with polycystic ovarian dis- ease resistant to ovulation induction with clomiphene citrate. Arch Gynecol Obstet 2010;281:939-944.
59. Bhagavath B, Carson SA. Ovulation induction in wom- en with polycystic ovary syndrome: an update. Am J Obstet Gynecol 2012;206:195-198.
60. Youssef H, Atallah MM. Unilateral ovarian drilling in polycystic ovarian syndrome: a prospective random- ized study. Reprod Biomed Online 2007;15:457-462.
61. Mercorio F, Mercorio A, Di Spiezio Sardo A, et al. Eval- uation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy. Fertil Steril 2008;89:1229-1233.
62. Seow KM, Juan CC, Hwang JL, Ho LT. Laparoscopic surgery in polycystic ovary syndrome: reproductive and metabolic effects. Semin Reprod Med 2008;2:101-110.
63. Wang XX, Luan CX, Zhang W, Hu SM. Pregnancy out- comes of in vitro fertilization and embryo transfer in in- fertile women with polycystic ovarian syndrome. Zhon- ghua Fu Chan Ke Za Zhi 2012;47:730-733.
64. Abu Hashim H, Wafa A, El Rakhawy M. Combined metformin and clomiphene citrate versus highly puri- fied FSH for ovulation induction in clomiphene-resistant PCOS women: A randomised controlled trial. Gynecol Endocrinol 2011;27:190-196.
65. Vause TD, Cheung AP, Sierra S, et al. Society of Obste- tricians and Gynecologists of Canada. Ovulation induc- tion in polycystic ovary syndrome. J Obstet Gynaecol Can 20;32:495-502.