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Hum. Reprod. Advance Access published online on July 8, 2005
Human Reproduction, doi:10.1093/humrep/dei128
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received December 30, 2004
Revised April 28, 2005
Accepted May 11, 2005

Article

Ovulation induction: a mini review

Ioannis E. Messinis 1*

1 Department of Obstetrics and Gynaecology, University of Thessalia, Medical School, 22 Papakiriazi Street, 41222 Larissa, Greece

* To whom correspondence should be addressed.
Ioannis E. Messinis, E-mail: messinis{at}med.uth.gr


  Abstract

Ovulation induction is the method for treating anovulatory infertility. For patients with hypogonadotrophic hypogonadism, the treatment involves administration of both FSH and LH, while HCG is injected for follicle rupture. Pulsatile GnRH has the same effectiveness as gonadotrophins and the advantage of the low multiple pregnancy rate. In polycystic ovary syndrome (PCOS), the first treatment choice is clomiphene citrate. With this drug, in properly selected patients, the cumulative pregnancy rate approaches that of normal women. Low-dose protocols of FSH are the second line of treatment, effective in inducing monofollicular development. Laparoscopic ovarian drilling can be an alternative but not as a first choice treatment in clomiphene-resistant patients. Other treatments, such as pulsatile GnRH and GnRH agonists, are hardly used today in PCOS. However, in obese women with PCOS, weight loss and exercise should be recommended as the first line of therapy. Newer agents including aromatase inhibitors and insulin sensitizers, although promising, need further evaluation.

Keywords: gonadotrophins/hypogonadotrophic hypogonadism/ovulation induction/polycystic ovary syndrome/pulsatile GnRH.
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