A study of different clinical and biochemical parameters in polycystic ovary syndrome affecting ovulation induction outcome and fertility potential

[摘要] Chapter 1 presents a literature study on the diagnostic debate of PCOS. The literature studyincludes a discussion of the recent Rotterdam consensus statement regarding the diagnosis ofPCOS. This is followed by a discussion on the essential work-up of the patient presenting withPCOS. Finally, chapter 1 presents a discussion on the complexity of the different variations inwomen presenting with PCOS.Chapter 2 is a literature review on ovulation induction methods in patients who present withPCOS. This literature study puts special emphasis on the different available methods used forovulation induction in women with PCOS and the profounding effect weight loss will have inmanaging these patients. This chapter also addresses the use of newer agents, like aromataseinhibitors (Letrozole), and the current role of each of these agents in ovulation induction protocols.Chapter 3 is a literature overview on the effect of Metformin in Clomiphene-resistant PCOSwomen. The inclusion criteria of this review was all prospective randomized trials where Metforminwas added for ovulation in the Clomiphene-resistant PCOS patient. The data is presented as a metaanalysis.Chapter 4 is a prospective randomise control trial to evaluate the benefit of metformin if added toClomiphene in a primary ovulation induction protocol in comparison to Clomiphene alone. Thischapter also evaluates all factors influencing ovulation outcome. Finally in the discussion section allthe recent studies published addressing this topic were reviewed.Chapter 5 is a literature review to evaluate the classification systems for semen parameters and thein vivo fertility potential. This data is also used to establish fertility/subfertility thresholds for semenparameters.This chapter also presents the results of a prospective and retrospective study of the semen analysisof the partners of women with PCOS. We believe that this population presents the best referencegroup to study the semen profile of the general male population.Chapter 6 is a summary of the results of these studies and serves as an evidence based approach forovulation induction in women with PCOS.

[发布机构] Stellenbosch University