Ovulation induction in anovulatory infertility is obsolete

Women with polycystic ovary syndrome make up the vast majority of patients with anovulatory infertility. The commonly accepted treatment guidelines recommend ovulation induction for timed intercourse as the first-line treatment. After a 2-year treatment period, the cumulative pregnancy rates with a...

Full description

Saved in:
Bibliographic Details
Published in:Reproductive biomedicine online 2023-02, Vol.46 (2), p.221-224
Main Authors: Lawrenz, Barbara, Melado, Laura, Fatemi, Human M.
Format: Article
Language:English
Subjects:
Anovulation
Female
Humans
Infertility, Female - etiology
Multiple pregnancy
Ovulation induction
Ovulation Induction - adverse effects
PCOS
Polycystic Ovary Syndrome - complications
Polycystic Ovary Syndrome - therapy
Pregnancy
Pregnancy Rate
Preimplantation genetic testing for aneuploidies
Prospective Studies
Single embryo transfer
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Women with polycystic ovary syndrome make up the vast majority of patients with anovulatory infertility. The commonly accepted treatment guidelines recommend ovulation induction for timed intercourse as the first-line treatment. After a 2-year treatment period, the cumulative pregnancy rates with a singleton live-born baby reached 71% and 78% in two prospective studies. Despite aiming for monofollicular growth, multifollicular responses with subsequent multiple/higher order multiple pregnancies are a dreaded risk associated with ovarian induction. However, the lengthy treatment, the increase of maternal age and the psychological effects of ‘obligatory intercourse’ are also factors challenging the concept of ovarian induction as the first treatment approach in anovulatory infertility. Nowadays, individualized IVF treatment with cycle segmentation, freeze-all strategies and single-embryo transfers in frozen embryo transfer cycles dramatically reduces the risk of multiple pregnancies, and a cumulative pregnancy rate of 83% can be achieved over three complete cycles, thereby reducing exposure to fertility medication and time to pregnancy. Although on first sight ovarian induction might present the easier and less costly approach, efficient and individualized IVF treatments with low complication rates and the chance of preventing multiple pregnancies challenge this concept, and it seems that the time has come to abandon ovarian induction in anovulatory infertility.
ISSN:1472-6483
1472-6491
DOI:10.1016/j.rbmo.2022.08.102