Strategies to improve the outcomes of assisted reproduction in women with polycystic ovarian syndrome: a systematic review and meta‐analysis

ConclusionThere is low to moderate quality evidence suggesting that antagonist protocols are preferable to agonist ones, because they reduce the incidence of OHSS without interfering with clinical pregnancy and live birth for women with PCOS. Additionally there is low quality evidence pointing a benefit for metformin supplementation on clinical pregnancy and live birth; and that the ovulation induction and estradiol seems to be equally effective for endometrial preparation before frozen embryo transfer for women with PCOS. For all other interventions, the quality of the evidence is of very low quality, not allowing any meaningful conclusions.
Source: Ultrasound in Obstetrics and Gynecology - Category: Radiology Authors: Tags: Systematic Review Source Type: research

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BACKGROUND: Forty-four percent of all pregnancies worldwide are unintended. Induced abortion has drawn a lot of attention from clinicians and policy makers, and the care for women requesting it has been covered in many publications. However, abortion chall...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
Conditions:   Erectile Dysfunction;   Penile Diseases Intervention:   Diagnostic Test: shear Wave Elastosonography Sponsor:   University Of Perugia Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Objective: To compare the effects of letrozole and human menopausal gonadotropin (HMG) in the treatment of patients with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC). Methods: A total of 96 clomiphene resistance polycystic ovary syndrome patients infertility were randomly divided into an LE group, and HMG group (n = 48). LE group orally received letrozole at 5.0 mg/d−1 on the 3rd–5th days of menstrual cycle for 5 consecutive days, and 75 U/d−1 HMG was given through intramuscular injection for 5 days starting from the third day of menstrual cycle in HMG group. Number o...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
CONCLUSIONS: There may be little or no difference in live birth, incidence of multiple pregnancy, clinical pregnancy rate, or miscarriage rate between urinary-derived gonadotrophins and recombinant follicle stimulating hormone in women with polycystic ovary syndrome. For human menopausal gonadotropin or highly purified human menopausal gonadotrophin versus urinary follicle stimulating hormone we are uncertain whether one or the other improves or lowers live birth, incidence of multiple pregnancy, clinical pregnancy rate, or miscarriage rate. We are uncertain whether any of the interventions reduce the incidence of ova...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusion(s) Letrozole-low dose gonadotropins combination appears to be effective across different causes of infertility for superovulation. The letrozole-low dose gonadotropin combination resulted in high rate of monofolliculogenesis, low occurrence of multiple gestations and no case of OHSS or cycle cancellation.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
In the past decades understanding of sex-related differences in the presentation of cardiovascular disease (CVD) has improved. Conditions leading to alterations in estrogen level such as menopause and polycystic ovary syndrome are associated with increased risk of CVD [1]. Studies have found that a history of recurrent miscarriages [2], gestational diabetes mellitus (GDM) [3] and pregnancy-induced hypertension [4] were associated with an increased risk of CVD. Some conditions such as Raynaud ’s phenomenon and migraine are found to have a female preponderance and further, migraine has been linked to increased cardiova...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
Andrea Syrtash was first hospitalized at the age of 14 for painful and heavy menstrual cycles due to endometriosis. She had no idea her condition would affect her fertility ― and even if she had known, she may not have thought to address it without guidance from her doctors. After six years of trying to conceive, Syrtash, who’s now in her 40s and works as a relationship and dating expert, recently founded pregnantish, a website for singles, couples and LGBTQ people who are trying to conceive.  “When you’re a teenager, it’s not on your mind,” she said. Had she known, “I migh...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
By Katrina Mark, MD 1. Fertility naturally declines as we age That alone doesn’t mean you should start to worry. The general advice I give a woman is if she has been trying to become pregnant for a full year with no luck, she might consider a fertility evaluation. For a woman over age 35, she might consider it after six months. If a woman is younger and has irregular periods, it’s likely she isn’t regularly ovulating, so she might want to be evaluated sooner. 2. Sometimes there’s a reason for infertility – and sometimes, there’s not There are some things we know cause infertility. About...
Source: Life in a Medical Center - Category: Universities & Medical Training Authors: Tags: Health Tips Women's Health fertility Katrina Mark obgyn UMMC Source Type: blogs
CONCLUSION: There is low to moderate quality evidence suggesting that antagonist protocols are preferable to agonist ones, because they reduce the incidence of OHSS without interfering with clinical pregnancy and live birth for women with PCOS. Additionally there is low quality evidence pointing a benefit for metformin supplementation on clinical pregnancy and live birth; and that the ovulation induction and estradiol seems to be equally effective for endometrial preparation before frozen embryo transfer for women with PCOS. For all other interventions, the quality of the evidence is of very low quality, not allowing any m...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
CONCLUSIONS: Although 14 RCTs were included in this review, few dealt with the same comparisons, all were small to moderate size and their methodological quality was generally poor. Any conclusions, therefore, remain tentative as they are based on a limited amount of data and will require further RCTs to substantiate them. In none of the comparisons was there a significant improvement in pregnancy rate but this may be due to the lack of power (i.e. insufficient patients randomised to demonstrate a significant difference between treatments). There was a trend towards better pregnancy rates with the addition of a GnRH-a to g...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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