Volume 21 Issue 5
May  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(5): 844-848
CAO Jiacheng, XIAO Yang, WANG Suxia. Research progress on the risk and prevention of ovulation induction in infertile patients with polycystic ovary syndrome[J]. Chinese Journal of General Practice, 2023, 21(5): 844-848. doi: 10.16766/j.cnki.issn.1674-4152.002997
Citation: CAO Jiacheng, XIAO Yang, WANG Suxia. Research progress on the risk and prevention of ovulation induction in infertile patients with polycystic ovary syndrome[J]. Chinese Journal of General Practice, 2023, 21(5): 844-848. doi: 10.16766/j.cnki.issn.1674-4152.002997
shu

Research progress on the risk and prevention of ovulation induction in infertile patients with polycystic ovary syndrome

doi: 10.16766/j.cnki.issn.1674-4152.002997
  • 1.

    Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China

Funds:

 2022ZZ025

  • Received Date: 2022-05-12
    Abstract
  • This study aimed to explore the risk with its mechanism and prevention measures of infertile patients with polycystic ovary syndrome (PCOS) after ovulation induction therapy. Literature was searched from several online databases, including CNKI, WanFang and PubMed, which were systematically evaluated to comprehensively understand its risks and pathogenesis, and the corresponding prevention and treatment measures were summarised to provide a basis for clinical treatment of the disease. Results are as follows, (1) Multiple pregnancy: the risk of multiple pregnancy with gonadotropin is significantly higher than that with oral ovulation stimulants, and the combination of letrozole or clomiphene with gonadotropin could not improve the outcome of multiple pregnancy. (2) Ovarian hyperstimulation syndrome (OHSS): human chorionic gonadotropin (HCG) has the highest risk of OHSS, and its dose and injection timing should be strictly controlled in clinical administration. Ovulation induction with gonadotropin releasing hormone (GnRH) is recommended for patients at high risk of OHSS, but the risk of luteal insufficiency should be monitored. (3) Luteinised unruptured follicle syndrome (LUFs): GnRH combined with HCG or clomiphene can effectively reduce this risk, but a large sample size is still lacking. (4) Empty follicle syndrome (EFS): it is commonly found in patients after ovulation induction by HCG or GnRH, and some studies suggest that prevention can be achieved by monitoring genetic markers. (5) Early abortion: metformin alone or in combination with ovulation induction drugs cannot reduce the risk of early abortion, and no significant difference in the risk of early abortion was observed between letrozole and clomiphene. (6) Diminished ovarian reserve (DOR): Anti-Müllerian hormone may be a good diagnostic indicator of PCOS infertility with DOR, however, further confirmation is needed. Based on the risk of various ovulation induction drugs, we hope that clinicians can select a more suitable treatment for infertile patients with PCOS to avoid the related risks and reduce the physiological and economic burden of infertile patients with PCOS.

     

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