COMPARISON OF THE EFFECTIVENESS OF OVULATION INDUCTION AND STIMULATION PROTOCOLS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME AND OBESITY
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i1.15243Keywords:
infertility, obesity, polycystic ovary syndrome, treatment, ovulation, in vitro fertilizationAbstract
SUMMARY. The aim – to evaluate the impact of obesity and determine the effectiveness of ovulation induction and superovulation stimulation protocols in patients with polycystic ovary syndrome (PCOS) in assisted reproductive technologies.
Material and Methods. A systematic review and comparative analysis of scientific publications and literature sources from the PubMed database over the past 5 years related to research in the field of reproductive medicine on the impact of polycystic ovary syndrome and obesity on the reproductive potential of women and methods of ovulation induction and superovulation stimulation in this group of patients was conducted.
Results. The analysis of literature data shows that the choice of methods to achieve ovulation and the desired pregnancy in patients with polycystic ovary syndrome and obesity should be individualized. Moderate weight loss achieved through lifestyle modification is the first line of therapy and helps to improve reproductive functions. Pharmacologic treatment of obesity, in particular the use of glucagon-like peptide-1 receptor agonists such as liraglutide, has been shown to be effective in reducing body weight and improving metabolic parameters in patients with PCOS. Letrozole, an aromatase inhibitor, is considered a first-line drug for inducing ovulation in women with PCOS and anovulatory infertility, providing higher cumulative pregnancy and fertility rates than clomiphene citrate. The use of myo-inositol may reduce the need for gonadotropins and improve ovarian response. Gonadotropin-releasing hormone antagonists show a better safety profile, reducing the risk of ovarian hyperstimulation syndrome, while progestin-primed ovarian stimulation can be an effective alternative. Long-term GnRH agonist protocol provides higher implantation rates but increases the risk of complications.
Conclusions. Polycystic ovary syndrome is a complex heterogeneous disease that requires an integrated approach to management. Thus, achieving ovulation in this group of patients requires an integrated approach, taking into account metabolic characteristics and risks.
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