Management ofanovulatory infertility associated with polycystic ovary syndrome (PCOS).

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and it appears to be difficult to induce the ovulation safely and successfully. Anovulation in PCOS is exacerbated by weight gain and improved by lifestyle modification and weight reduction. If these measures are not successful, conception can usually be achieved with the use of clomiphene citrate, metformin alone or in combination with clomiphene citrate, gonadotrophins, surgical ovulation induction using laparoscopically applied techniques to the ovaries and assisted reproductive techniques. One of the main goals of ovulation induction is to avoid multiple follicular developments that may result in overstimulation, leading to cycle cancellation and complications such as multiple pregnancies and ovarian hyperstimulation syndrome (OHSS). Fertility can usually be restored by appropriate choice of induction of ovulation, but careful monitoring is required.