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Managing anovulatory infertility and polycystic ovary syndrome

Summary points Polycystic ovary syndrome is the most common endocrine problem affecting women and the most common cause of anovulatory infertility Oral clomifene citrate remains the first line treatment to induce ovulation Gonadotrophin treatment needs careful monitoring to reduce risk of multiple p...

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Bibliographic Details
Published in:BMJ 2007-09, Vol.335 (7621), p.663-666
Main Authors: Balen, Adam H, Rutherford, Anthony J
Format: Article
Language:English
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Summary:Summary points Polycystic ovary syndrome is the most common endocrine problem affecting women and the most common cause of anovulatory infertility Oral clomifene citrate remains the first line treatment to induce ovulation Gonadotrophin treatment needs careful monitoring to reduce risk of multiple pregnancy Despite early promise, the role of metformin and insulin lowering agents is unclear in the management of anovulatory polycystic ovary syndrome Sources and selection criteria We referred to the Cochrane database of systematic reviews, The National Institute for Health and Clinical Excellence (NICE) guidelines for the investigation and management of infertility (2004), and our knowledge of the current literature. Obesity has a profound effect on both natural and assisted conception-it influences the chance of becoming pregnant and the likelihood of a healthy pregnancy. 10 Obesity is associated with increased rates of congenital anomalies (neural tube defects and cardiac defects), miscarriage, gestational diabetes, hypertension, problems during delivery, stillbirth, and maternal mortality. 11 Of the 261 deaths reported between 2000 and 2002 to the UK Confidential Enquiry into Maternal Health, 78 women (35%) were obese, compared with 23% of women in the general population, and of these more than a quarter had a body mass index (BMI) >35.
ISSN:0959-8138
0959-8146
0959-535X
1468-5833
1756-1833
DOI:10.1136/bmj.39335.462303.80