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Chapter 13 - In Vitro Fertilization and Assisted Reproductive Technologies in Polycystic Ovary Syndrome

Published online by Cambridge University Press:  13 May 2022

Gabor T. Kovacs
Monash University, Melbourne, Australia
Bart Fauser
University Medical Center, Utrecht, Netherlands
Richard S. Legro
Penn State Medical Center, Hershey, PA, USA
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In vitro fertilization (IVF) should be viewed as a third-line treatment for those with polycystic ovary syndrome (PCOS). In the absence of known causative factors of infertility, such as tubal or sperm abnormalities, a methodical approach to treatment should first include lifestyle modification and an efficacious trial of ovulation induction (OI). Cumulative pregnancy rates of 62% within 4 treatment cycles have been shown with letrozole, an aromatase inhibitor[1] – now widely accepted as the first-line OI agent in PCOS.[2, 3] For those who remain refractory to different regimens of OI, the move to IVF, with the associated risk of ovarian hyperstimulation syndrome (OHSS), becomes justified. The presence of polycystic ovaries is a major risk factor for OHSS, necessitating careful planning of gonadotropin stimulation.

Publisher: Cambridge University Press
Print publication year: 2022

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