Ovulation Induction Protocol In Pcos

The traditional protocol using letrozole for ovulation induction is identical to the protocol used with cc. These women are treated by stimulating ovulation with medication so called ovulation induction. Unfortunately many pcos women both lean and obese behave erratically during ovulation induction sometimes leading to ovarian hyperstimulation syndrome which can become a serious iatrogenic complication.

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The american college of obstetricians and gynecologists acog now recommends letrozole aromatase inhibitor as the first line treatment for ovulation induction in women with polycystic ovarian syndrome pcos due to data demonstrating increased ovulation rates clinical pregnancy rates and live birth rate vs clomiphene citrate.

Ovulation induction protocol in pcos. Infertility due to ovulation disorders is the most common reason for women to seek counselling or treatment. This is usually done with tablets containing clomiphene citrate as the first line of treatment. Clomiphene citrate has been proven effective in ovulation induction for women with pcos and should be considered the first line therapy. Cc metformin improves ovulation and pregnancy rates compared with cc alone in women with cc resistant pcos.

Typical treatment begins with the lowest dose of the medication for 5 days starting on cycle day 3 5 after a spontaneous menses or after a progestin induced withdrawal bleed. Clomiphene citrate has been proven effective in ovulation induction for women with pcos and should be considered the first line therapy. Letrozole step up protocol for ovulation induction in infertile women with pcos the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The clinical approach to ovulation induction requires an understanding of the causes of anovulation.

Letrozole is a reasonable first line agent for ovulation induction. The four most common ovulatory disorders include hypogonadotropic hypogonadism ha polycystic ovary syndrome pcos primary ovarian insufficiency poi and hyperprolactinemia see clinical manifestations and evaluation of hyperprolactinemia. Metformin combined with clomiphene citrate may increase ovulation rates and pregnancy rates but does not significantly improve the live birth rate over that of clomiphene citrate alone. Pretreatment with metformin for at least 3 months followed by the addition of another ovulation inducing drug increases the live birth rate.

Pharmacological agents used for ovulation induction either block estrogen receptors or block estrogen synthesis and hence release the hypothalamo pituitary ovarian hpo axis from the negative feedback effect of plasma estrogen thereby facilitating follicular growth and ovulation. Listing a study does not mean it has been evaluated by the u s. Of the most treatable forms of infertility if ovulation induction is optimal. Patients should be informed that there is an increased risk of multiple pregnancy with ovulation induction using clomiphene citrate.