Fertility Issues in Polycystic Ovarian Disease: A Systematic Approach.

The triad of hirsutism, amenorrhea, and enlarged polycystic ovaries first was described in 1935 and later become known as polycystic ovarian syndrome (PCOS). Women with PCOS are more likely to have cardiometabolic challenges that also have an indirect relationship to their fertility and fertility outcomes. Despite these challenges, their fertile life span appears to be longer. Ovulation induction is considered first-line management of infertility in women with PCOS, with letrozole superior to clomiphene. Women with PCOS undergoing in vitro fertilization are high risk for ovarian hyperstimulation syndrome but also have a higher live birth rate compared with controls.