多囊卵巢综合征相关不孕症的二线和三线治疗及证据支持

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Abstract In Clomiphene resistant anovulatory patients with polycystic ovary syndrome (PCOS) and no other infertility factors, either Metformin combined with Clomiphene citrate or Gonadotrophins could be used as a second-line pharmacological therapy, although Gonadotrophins are more effective. Gonadotrophins could also be used as a second-line pharmacological therapy in anovulatory patients with PCOS and Clomiphene failure. Laparoscopic ovarian surgery can also be used as a second-line therapy for ovulation induction in anovulatory patients with Clomiphene resistant PCOS and no other infertility factors. The usefulness of Letrozole as a second-line pharmacological treatment for ovulation induction in Clomiphene resistant women with PCOS requires further research. In terms of improving fertility, both pharmacological anti-obesity agents and bariatric surgery should be considered an experimental therapy in anovulatory women with PCOS and no other infertility factors. First-or second-line ovulation induction therapies have failed, in vitro fertilization (IVF)/intracytoplasmic single sperm injection (ICSI) could be offered as a third-line therapy in patients with PCOS in the absence of an absolute indication for IVF/ICSI. However, absolute indications for IVF/ICSI are lacking. For patients with PCOS undergoing IVF/ICSI treatment, the gonadotropin-releasing hormone antagonist protocol is preferred and an elective frozen embryo transfer strategy could be considered. In assisted conception units with sufficient expertise, in-vitro maturation of oocytes could be offered to women with PCOS.

Key words： Polycystic ovary syndrome Infertility Treatments Evidence

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	WANG Yaoyao1 HAO Songli2▲

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WANG Yaoyao1 HAO Songli2▲. The second- and third-line treatments and supporting evidence of polycystic ovary syndrome-related infertility[J]. 中国医药导报, 2020, 17(10): 46-49.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I10/46

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