News: A concensus on the Rx for PCOS infertility

Treatment of infertility in women with polycyctic ovary syndrome (PCOS).

Experts from around the globe met recently in Greece to develop a consensus regarding treatment of infertility in women with polycystic ovary syndrome (PCOS).

They agreed that before considering medical treatment, physicians should counsel patients on the importance of lifestyle changes including weight reduction, exercise, smoking, and alcohol consumption.

They also agreed that treatment should be tailored to each patient's individual circumstances, but that generally first-line treatment should consist of the anti-estrogen clomiphene citrate (CC) for ovulation induction. If this fails to result in pregnancy, second-line treatment should consist of either exogenous gonadotropins with intense monitoring of ovarian response because of the high chance for multiple pregnancy or laparoscopic ovarian surgery. Because the latter as a lone method is effective in fewer than 50% of women, additional ovulation induction medication is usually required. Treatment with CC and gonadotropins is associated with a cumulative singleton live-birth rate of 72%. Third-line treatment should consist of in vitro fertilization.

Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril. 2008;89:505-522.