Management strategy of infertility in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disease in women of reproductive age. PCOS is characterized by ovulatory disruption, which can lead to infertility. Patients with PCOS are also more likely to have poor pregnancy outcomes. For obese women, lifestyle interventions are recommended first, which have general health benefits. For women who have difficulty changing their lifestyle, drugs for the treatment of obesity or bariatric surgery could be considered. Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past. Letrozole is supplanting clomiphene as the best option for ovulation induction for now, particularly in patients with PCOS. Metformin can improve ovulation and pregnancy rates; however, it has minimal effects in terms of raising live birth rates. Second-line therapies include gonadotropins and laparoscopic ovary drilling. In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors. In summary, to achieve fertility, patients with PCOS require standardized individualized therapy.