THE CHOICE OF TREATMENT FOR ANOVULATION ASSOCIATED WITH POLYCYSTIC-OVARY-SYNDROME FOLLOWING FAILURE TO CONCEIVE WITH CLOMIPHENE

被引:25
作者
FARHI, J
HOMBURG, R
LERNER, A
BENRAFAEL, Z
机构
[1] GOLDA MEIR MED CTR, DEPT OBSTET & GYNAECOL, INFERTIL UNIT, IL-49372 PETAH TIQWA, ISRAEL
[2] TEL AVIV UNIV, SACKLER SCH MED, TEL AVIV, ISRAEL
关键词
ANOVULATION; INFERTILITY TREATMENT; POLYCYSTIC OVARY TREATMENT;
D O I
10.1093/oxfordjournals.humrep.a138262
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The choice of treatment for clomiphene-resistant anovulation associated with polycystic ovary syndrome (PCOS) is presently arbitrary and selection criteria are not available. A total of 144 women with anovulatory infertility associated with PCOS who failed to conceive on clomiphene were treated with either pure follicle stimulating hormone (FSH) (n = 29), or human menopausal gonadotrophin (HMG) (n = 60), or gonadotrophin-releasing hormone analogue (GnRHa) and HMG (n = 55). Analysis of 306 treatment cycles and 53 pregnancies revealed a cumulative conception rate at 4 months of 23% with FSH, 47% with HMG and 69% with GnRHa + HMG. The miscarriage rate was highest in the HMG group (44%) and consequently the cumulative live birth rate was superior when GnRHa was used in combination with HMG. There were no significant differences in the basal clinical and endocrinological features of those who conceived compared with those who did not, either in the whole group, or in the individual treatment groups. Thus, the choice of treatment for clomiphene-resistant women with PCOS cannot be guided by the basal clinical or endocrinological features of this heterogeneous syndrome with the present state or knowledge.
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页码:1367 / 1371
页数:5
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