Alejandro Aldape Arellano
Spanish Fertility Society, Spain
Title: A fertility approach of first and second line treatments in PCOS
Biography
Biography: Alejandro Aldape Arellano
Abstract
Poly Cystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. According to National Institute of Health (NIH) the prevalence is around 4-10%. Nowadays lifestyle changes such as exercise and calorie-restricted diet seems to be cost-effective excellent option considering that up to 76% of diseased woman present obesity. There is no discussion about effectiveness of clomiphene citrate (CC) as first line treatment of anovulatory infertility; however, we do not have a clear protocol of drugs when there is comorbidity (insulin resistance, high adrenal androgen, hyperprolactinemia). Therefore a complete evaluation and individualized treatment is mandatory. Second line treatments include ovulation induction with gonadotropins and laparoscopic ovarian drilling (LOD) most studies granted in general terms same results with some concerns about multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) on the gonadotropin arm and premature ovarian failure (POF) on LOD arm. Anyway, whether we consider a first or second line therapy we cannot forget that the main problem in women of reproductive age is infertility therefore it is not just and individual problem but couple. A fertility approach means making an evaluation and diagnosis of both partners because only then we will know if the proposed algorithm remains in effect for a particular couple.