Does ovulation induction with follicle-stimulating hormone still have a future in polycystic ovary syndrome?

Author:
Robert John Norman, M.D.

Volume 98, Issue 3, Pages 599, September 2012

Abstract:
Reflections on “High singleton live birth rate confirmed after ovulation induction in women with anovulatory polycystic ovary syndrome: validation of a prediction model for clinical practice”

  • I have said ovulation induction with FSH is a dying art. Maybe it is not being taught properly, does not bring in enough income and is too difficult. My article indicated that it is a particularly skiled procedure all reproductive medicine doctors should learn. I wonder if others agree?

    • Great challenge Robert— when I was a fellow we treated OI as a delicate art balancing dosages and timings and number of targeted ovulation with the patient’s age diagnosis semen parameters and personal desires. I think you are correct for some practitioners today the effort and individualization required is beyond what they are willing to do. While I am very happy with my personal low rates of multiples with OI the success per month obviously pales compared to my IVF cases. I think OI is similar to tubal reconstructive surgery. When done properly it can be a wonderful treatment that perfectly meets the patient’s needs but it potentially requires effort and thinking and finesse that some won’t be willing to do–and per month is does not equal IVF. When I review charts from other centers I do see that many places do not individualize OI and when done that way it becomes an even poorer alternative. Looking to the future if we reach a point where we have simplified and lower cost ART with single embryo transfers and genetic screening for aneuploidy and success rates >75% OI I think will be reserved for anovulation mainly.

      • Thanks Steven. I guess there can be confusion with terminolgy between OI with IUi for unexplined infertility (where IVF is clearly superior) and OI for anovulation (ie pCOS, hypothalamic amenorrhea) which was the point of my article

        • Robert– sorry to divert the discussion– yes I understand your paper on OI however i saw this as a springboard to talk about supra-ovulation GT’s for unexplained as a related subject. sorry to digress!.

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