Progress in ovarian stimulation.

It is uncertain whether patients who do not ovulate but fail to conceive following CC therapy behave differently during gonadotropin therapy. However, if the infertile patient with PCOS is resistant to anti-estrogen therapy, gonatropin treatment administered through low dose protocols should be considered. As compared to conventional regimens, complication rates are reduced despite similar efficacy. It should be recognized that patients with PCOS constitute a very heterogeneous group. Therapy outcome may benefit from improved classification. The identification of clinical characteristics that identify those women with anovulation who are unlikely to respond to clomiphene would permit earlier use of gonadotropin therapy and potentially offer major health and economic benefits. Furthermore, if ovarian responsiveness to ovulation-induction therapy could be predicted for an individual patient, it might be possible to devise regimens that reduced the risk of ovarian hyperstimulation and multiple pregnancy.