From the Guidelines
Women with Polycystic Ovary Syndrome (PCOS) have a significantly higher risk of infertility, with approximately 70-80% experiencing difficulties conceiving, as indicated by the effectiveness of clomiphene citrate in inducing ovulation in about 80 percent of women with PCOS, with one half of these patients conceiving 1.
Key Points
- The elevated infertility rate in women with PCOS is primarily due to hormonal imbalances that affect ovulation, characterized by irregular or absent menstrual cycles, which often indicates infrequent or absent ovulation.
- PCOS is also associated with elevated levels of androgens (male hormones) and insulin resistance, both of which can interfere with normal reproductive function.
- While the infertility rate is high, it doesn't mean all women with PCOS are infertile, as many can still conceive naturally or with the help of fertility treatments.
- The chances of conception can be improved through lifestyle modifications such as weight loss (if overweight), regular exercise, and a balanced diet, as well as medical interventions like ovulation induction medications (e.g., clomiphene citrate or letrozole) or assisted reproductive technologies.
Diagnosis and Treatment
- The diagnosis of PCOS is supported by imaging findings of polycystic ovarian morphology (PCOM), defined as >25 small follicles in at least one ovary or a single ovarian volume >10 mL on transvaginal ultrasound (TVUS) 1.
- Early diagnosis and personalized treatment plans are crucial in improving the chances of conception for women with PCOS, with regular monitoring of ovulation and timely medical intervention playing a significant role.
- The use of clomiphene citrate is recommended as a first-line treatment for ovulation induction in women with PCOS, due to its effectiveness and safety profile 1.
From the Research
Infertility Rate in Women with PCOS
- The rate of infertility in women with Polycystic Ovary Syndrome (PCOS) is approximately 75% due to anovulation, making PCOS the most common cause of anovulatory infertility 2.
- Other studies suggest that PCOS represents 80% of anovulatory infertility cases 3, 4.
Prevalence of PCOS in Infertile Women
- Approximately 80% of women who suffer from anovulatory infertility have PCOS 4.
- PCOS is a predominant cause of infertility, affecting 7 to 15% of women in reproductive age 5.
Treatment of Infertility in Women with PCOS
- Lifestyle changes, such as weight loss, are considered the first-line treatment for infertile women with PCOS who are overweight or obese 2, 4, 5.
- Clomiphene citrate is often used as the first-line pharmacological treatment for inducing ovulation in women with PCOS 2, 3, 4, 5.
- Other treatment options include letrozole, metformin, gonadotropins, laparoscopic ovarian surgery, and in vitro fertilization (IVF) 2, 3, 4, 6, 5.