REVIEW  PCOS UPDATE 

Minerva Obstetrics and Gynecology 2025 Mar 06

DOI: 10.23736/S2724-606X.24.05633-1

Copyright © 2024 EDIZIONI MINERVA MEDICA

lingua: Inglese

Ovulation induction in anovulatory PCOS women

Marialaura DIAMANTI, Antonio LA MARCA ✉

Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder characterized by hyperandrogenism, chronic anovulation, and polycystic ovarian morphology, affecting 6-10% of women during their reproductive years. It is a leading cause of female infertility, impacting up to 40% of cases. First described in 1935, PCOS manifests with various clinical features, including hirsutism, amenorrhea, and metabolic disturbances. Additionally, PCOS patients exhibit hormonal imbalances and ovarian dysfunction, contributing to the overall clinical picture. Notably, PCOS is linked to metabolic comorbidities like hepatic steatosis, glucose intolerance, dyslipidemia, type 2 diabetes mellitus (T2DM), and hypertension. This review explores the key aspects of PCOS, providing an overview of ovulation induction strategies, including lifestyle modifications, pharmacological interventions, and emerging approaches. The review synthesizes findings from relevant studies. Effective management of PCOS necessitates early detection and intervention to prevent progression to severe health conditions. Evidence underscores the importance of addressing oxidative stress and low-grade inflammation in treatment plans. A holistic approach, including individualized medication, diet, and lifestyle modifications, is crucial for improving insulin resistance, promoting weight loss, enhancing ovulation rates, and addressing broader metabolic concerns. Key therapeutic strategies include insulin sensitizers like metformin, ovulation induction agents like clomiphene citrate (CC) and aromatase inhibitors (AIs) such as letrozole, and the use of gonadotropins for resistant cases. Combining these treatments with dietary and lifestyle interventions, such as an anti-inflammatory diet, nutritional education, and personalized exercise programs, can enhance treatment outcomes. Through an integrated approach, significant improvements in metabolic health and reproductive function for women with PCOS are possible.

KEY WORDS: Polycystic ovary syndrome; Infertility, female; Endocrine system diseases; Anovulation