Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.

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We summarize Thessaloniki Consensus’ conclusions for infertile women with polycystic ovary syndrome (PCOS) that wish to become pregnant. The Consensus indicates that first all other health problems and male infertility have to be excluded, and then continue with preconceptional counseling on life st...

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Autor: Pacheco Romero, José
Formato: artículo
Fecha de Publicación:2015
Institución:Sociedad Peruana de Obstetricia y Ginecología
Repositorio:Revista Peruana de Ginecología y Obstetricia
Lenguaje:español
OAI Identifier:oai:ojs.pkp.sfu.ca:article/1103
Enlace del recurso:http://51.222.106.123/index.php/RPGO/article/view/1103
Nivel de acceso:acceso abierto
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spelling Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.Manejo del síndrome de ovario poliquístico en la mujer infértil. Notas recientes sobre el Concenso de Thessaloniki.Pacheco Romero, JoséWe summarize Thessaloniki Consensus’ conclusions for infertile women with polycystic ovary syndrome (PCOS) that wish to become pregnant. The Consensus indicates that first all other health problems and male infertility have to be excluded, and then continue with preconceptional counseling on life style, advising on lowering weight and exercise in overweight women, and discontinuing smoking and alcohol consumption. Recommended first line treatment for ovulation induction is still the antiestrogen clomiphene citrate. When clomiphene fails, second line treatment consists in using exogenous gonadotropins or laparoscopic ovarian diathermia. The third line of treatment is in vitro fertilization – FIV. GnRh antagonists use may lower the incidence of ovary hyperestimulation syndrome. Single embryo transference in (young) women with PCOS subjected to FIV is expected to correlate with the possibility of less multiple pregnancy. Other ovulation induction treatments adjusted to each PCOS patient are expected to be developed. Metformin use in PCOS for ovulation induction is not currently recommended and there is insufficient evidence to recommend aromatase inhibitors use in ovulation induction. Even single fetuses pregnancies in PCOS are associated with mother and fetus health risks.Se hace un resumen de las conclusiones del Consenso de Thessaloniki, para el manejo de la infertilidad en la mujer con síndrome de ovario poliquístico (SOPQ) que desea gestar. El Consenso señala que primero se debe excluir otros problemas de salud o de infertilidad en la pareja, para luego realizar consejería preconcepcional sobre el estilo de vida, disminuir de peso y recomendar el ejercicio en la mujer con sobrepeso, dejar el cigarrillo y no consumir alcohol. La primera línea de tratamiento recomendada para la inducción de la ovulación sigue siendo el antiestrógeno citrato de clomifeno. La segunda línea, si fallara el clomifeno, consiste en usar las gonadotropinas exógenas o la diatermia ovárica vía laparoscópica. La tercera línea de tratamiento es la fertilización in vitro – FIV. El empleo de antagonistas de GnRH podría disminuir la incidencia de síndrome de hiperestimulación ovárica. Se espera que la transferencia de un embrión solo en mujeres (jóvenes) con SOPQ sometidas a FIV se correlacione con disminución de la posibilidad de embarazo múltiple. Se espera el desarrollo de otros tratamientos de inducción de la ovulación ajustados a cada paciente con SOPQ. El empleo de metformina en el SOPQ en la inducción de la ovulación no es recomendable y, actualmente, existe evidencia insuficiente para recomendar el uso de inhibidores de la aromatasa en la inducción de la ovulación. Aún los embarazos con fetos únicos en el SOPQ se asocian con mayores riesgos en la salud de la madre y el feto.Sociedad Peruana de Obstetricia y Ginecología2015-06-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://51.222.106.123/index.php/RPGO/article/view/1103The Peruvian Journal of Gynecology and Obstetrics ; Vol. 54 No. 2 (2008); 143-148Revista Peruana de Ginecología y Obstetricia; Vol. 54 Núm. 2 (2008); 143-1482304-51322304-5124reponame:Revista Peruana de Ginecología y Obstetriciainstname:Sociedad Peruana de Obstetricia y Ginecologíainstacron:SPOGspahttp://51.222.106.123/index.php/RPGO/article/view/1103/pdf_121info:eu-repo/semantics/openAccessoai:ojs.pkp.sfu.ca:article/11032015-08-07T15:05:59Z
dc.title.none.fl_str_mv Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
Manejo del síndrome de ovario poliquístico en la mujer infértil. Notas recientes sobre el Concenso de Thessaloniki.
title Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
spellingShingle Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
Pacheco Romero, José
title_short Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
title_full Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
title_fullStr Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
title_full_unstemmed Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
title_sort Polycystic ovary syndrome treatment in the infertile woman. Notes on the recent thessaloniki Consensus.
dc.creator.none.fl_str_mv Pacheco Romero, José
author Pacheco Romero, José
author_facet Pacheco Romero, José
author_role author
description We summarize Thessaloniki Consensus’ conclusions for infertile women with polycystic ovary syndrome (PCOS) that wish to become pregnant. The Consensus indicates that first all other health problems and male infertility have to be excluded, and then continue with preconceptional counseling on life style, advising on lowering weight and exercise in overweight women, and discontinuing smoking and alcohol consumption. Recommended first line treatment for ovulation induction is still the antiestrogen clomiphene citrate. When clomiphene fails, second line treatment consists in using exogenous gonadotropins or laparoscopic ovarian diathermia. The third line of treatment is in vitro fertilization – FIV. GnRh antagonists use may lower the incidence of ovary hyperestimulation syndrome. Single embryo transference in (young) women with PCOS subjected to FIV is expected to correlate with the possibility of less multiple pregnancy. Other ovulation induction treatments adjusted to each PCOS patient are expected to be developed. Metformin use in PCOS for ovulation induction is not currently recommended and there is insufficient evidence to recommend aromatase inhibitors use in ovulation induction. Even single fetuses pregnancies in PCOS are associated with mother and fetus health risks.
publishDate 2015
dc.date.none.fl_str_mv 2015-06-28
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publisher.none.fl_str_mv Sociedad Peruana de Obstetricia y Ginecología
dc.source.none.fl_str_mv The Peruvian Journal of Gynecology and Obstetrics ; Vol. 54 No. 2 (2008); 143-148
Revista Peruana de Ginecología y Obstetricia; Vol. 54 Núm. 2 (2008); 143-148
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