Ovulation Induction in Women with Polycystic Ovary Syndrome: What is the Optimal Option?
Infertility is a distressing medical and psychosocial problem afflicting about a quarter of all couples wanting to reproduce their offspring. Majority of the anovulatory problem in the female, as a cause of infertility, is due to polycystic ovary syndrome (PCOS) This condition is a complex interplay of factors, which affect women even beyond their fertility. It has been found to increase the risk of other adverse conditions such as the metabolic syndrome, cardiovascular diseases, type II diabetes mellitus, and endometrial cancer as well as infertility. Different groups have made diagnosis of PCOS with various diagnostic criteria. The Rotterdam criteria used in the diagnosis of PCOS mainly emphasize the reproductive malfunctions of this complex disease. The treatment of anovulatory infertility in PCOS is as enigmatic as the disease itself. Various methods have been deployed to treat the anovulation with variable success. Clomiphene citrate is a traditional first line drug in treating anovulation in women with PCOS. Weight reduction, letrozole, metformin, folliclestimulating hormone (FSH) and ovarian drilling are some of the other ways in which anovulation has been treated in these women. What method is more likely to succeed in treating the infertility from anovulation in PCOS and in what circumstance are the subject matters of this discussion.