Authors : Supriya Kumari

Volume/Issue : Volume 10 - 2025, Issue 5 - May

Google Scholar : https://tinyurl.com/4636rvwc

DOI : https://doi.org/10.38124/ijisrt/25may1556

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : The main cause in anovulatory infertility is PCOS, that affects 7–15% in women who are of reproductive age. Infertility impacts about 15% of couples and requires thorough evaluation, including history, physical, gynaecological, and endocrine assessments. The treatment of choice for PCOS-related infertility is clomiphene citrate. If it is ineffective, low- dose FSH stimulation is used to avoid problems such ovarian hyperstimulation and repeated pregnancies. Inhibitors of aromatase are new substitutes. Ovulation is improved by weight loss as well as insulin-sensitizing medications like metformin, though metformin is not advised unless metabolic issues are present. Myoinositol is a newer option under investigation. When medications fail, surgical methods such as laparoscopic ovarian drilling or transvaginal hydro laparoscopy are considered, particularly effective in lean women with high LH. IVF and in vitro maturation, which have outstanding success rates, are third-line choices. With current therapies, most women with PCOS-related infertility can achieve ovulation and pregnancy.

Keywords : PCOS, Hormone, Syndrome, Cyst, Infertility.

References :

1. Bozdag, G., S. Mumusoglu, D. Zengin, E. Karabulut, and B.O. Yildiz. 2016. “The Prevalence and Phenotypic Features of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.” Human Reproduction 31: 2841–2855.
2. Fauser, B.C., B.C. Tarlatzis, R.W. Rebar, et al. 2012. “Consensus on Women's Health Aspects of Polycystic Ovary Syndrome (PCOS): The Amsterdam ESHRE/ASRM- Sponsored 3rd PCOS Consensus Workshop Group.” Fertility and Sterility 97: 28– 38.e25.
3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. 2004. “Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome (PCOS).” Human Reproduction 19: 41–47.
4. Escobar-Morreale, H.F. 2018. “Polycystic Ovary Syndrome: Definition, Aetiology, Diagnosis and Treatment.” Nature Reviews Endocrinology 14: 270–284.
5. National Collaborating Centre for Women’s and Children’s Health. 2013. Fertility: Assessment and Treatment for People with Fertility Problems. London: Royal College of Obstetricians & Gynaecologists.
6. Hamilton-Fairley, D., and A. Taylor. 2003. “Anovulation.” BMJ 327: 546–549.
7. ESHRE Capri Workshop Group. 2012. “Health and Fertility in World Health Organization Group 2 Anovulatory Women.” Human Reproduction Update 18: 586– 599.
8. Helvaci, N., and E. Karabulut. 2017. “Polycystic Ovary Syndrome and the Risk of Obstructive Sleep Apnea: A Meta-Analysis and Review of the Literature.” Endocrine Connections 6: 437–445.
9. Bruyneel, A., S. Catteau-Jonard, C. Decanter, et al. 2014. “Polycystic Ovary Syndrome: What Are the Obstetrical Risks?” Gynecologie Obstetrique Fertilite 42: 104–111.
10. Teede, H.J., M.L. Misso, M.F. Costello, et al. 2018. “Recommendations from the International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.” Fertility and Sterility 110: 364–379.
11. Diamanti-Kandarakis, E.K.H., and R.S. Legro. 2006. “The Role of Genes and Environment in the Etiology of PCOS.” Endocrine 30: 19–26.
12. Pasquali, R., F. Casimirri, and V. Vicennati. 1997. “Weight Control and Its Beneficial Effect on Fertility in Women with Obesity and Polycystic Ovary Syndrome.” Human Reproduction 12 (Suppl 1): 82–87.
13. Kiddy, D.S., D. Hamilton-Fairley, A. Bush, et al. 1992. “Improvement in Endocrine and Ovarian Function during Dietary Treatment of Obese Women with Polycystic Ovary Syndrome.” Clinical Endocrinology 36: 105–113.
14. Legro, R.S., W.C. Dodson, A.R. Kunselman, et al. 2016. “Benefit of Delayed Fertility Therapy with Preconception Weight Loss over Immediate Therapy in Obese Women with PCOS.” Journal of Clinical Endocrinology & Metabolism 101: 2658–2666.
15. Moran, L.J., R. Pasquali, H.J. Teede, K.M. Hoeger, and R.J. Norman. 2009. “Treatment of Obesity in Polycystic Ovary Syndrome: A Position Statement of the Androgen Excess and PCOS Society.” Fertility and Sterility 92: 1966–1982.
16. Hakimi, O., and L.C. Cameron. 2017. “Effect of Exercise on Ovulation: A Systematic Review.” Sports Medicine 47: 1555–1567.
17. Brennan, L., H. Teede, H. Skouteris, J. Linardon, B. Hill, and L. Moran. 2017. “Lifestyle and Behavioral Management of Polycystic Ovary Syndrome.” Journal of Women’s Health 26: 836–848.
18. Denis, A.M. 2006. “Ovarian Enzyme Activities in Women with Polycystic Ovary Syndrome.” Fertility and Sterility 86 (1): 9–11.
19. Akram, N.R. Muhammad. 2015. “Endocrine Correlates of Polycystic Ovary Syndrome in Pakistani Women.” Journal of the College of Physicians and Surgeons Pakistan 25 (1): 22–26.
20. Homburg, R. 2005. “Clomiphene Citrate—End of an Era? A Mini-Review.” Human Reproduction 20: 2043–2051.
21. Legro, R.S., H.E. Barnhart, K. Schlaff, et al. 2007. “Clomiphene, Metformin, or Both for Infertility in the Polycystic Ovary Syndrome.” New England Journal of Medicine 356: 551–566.
22. Sirmans, S.M., and K.A. Pate. 2014. “Epidemiology, Diagnosis, and Management of Polycystic Ovary Syndrome.” Clinical Epidemiology 6: 1–13.
23. Wickenheisser, J.K., J.E. Quinn, and S.E. Nelson-Degrave. 2000. “Differential Regulation of Aromatase and Steroidogenic Acute Regulatory Protein Messenger Ribonucleic Acid Levels in Granulosa Cells from Polycystic Ovaries.” Journal of Clinical Endocrinology & Metabolism 85: 4468–4473.
24. Palomba, S., A. Santagni, R. Falbo, and G. La Sala. 2015. “Complications and Challenges Associated with Polycystic Ovary Syndrome: Current Perspectives.” International Journal of Women’s Health 7: 745–763.
25. Vanky, E., E. Salvesen, E. Heimstad, L.J. Fougner, and S. Romundstad. 2010. “Metformin Reduces Pregnancy Complications Without Affecting Androgen Levels in Pregnant Women with Polycystic Ovary Syndrome: Results of a Randomized Study.” Human Reproduction 25: 1749–1757.
26. Tso, L.O., C. Costello, M.F. Albuquerque, et al. 2020. “Metformin for Women with Polycystic Ovary Syndrome.” Cochrane Database of Systematic Reviews 12: CD003053.
27. Al-Kuraishy, H.M., A.N. Al-Gareeb, M.S. Al-Nami, and A.N. Alexiou. 2019. “Rosuvastatin Attenuates Oxidative Stress and Inflammation in Polycystic Ovary Syndrome: Role of Adiponectin.” International Journal of Reproductive Biomedicine 17 (12): 883–892.
28. Casper, R.F. 2007. "Aromatase Inhibitors in Ovarian Stimulation." Journal of Steroid Biochemistry and Molecular Biology 106: 71–75.
29. Johnson, N.P. 2011. “Metformin Use in Women with Polycystic Ovary Syndrome.” Annals of Translational Medicine 2 (6): 56–62.
30. Vrbikova, J., and J. Hainer. 2009. “Obesity and Polycystic Ovary Syndrome.” Obesity Facts 2 (1): 26–35.
31. Welt, C.K., A. Gudmundsson, C.A. Arason, et al. 2006. “Characterizing Discrete Subtypes of Polycystic Ovary Syndrome (PCOS) Based on a Large Population of Icelandic Women.” Human Reproduction 21: 435–443.
32. Diamanti-Kandarakis, E., and A.D. Papavassiliou. 2006. “Molecular Mechanisms of Insulin Resistance in Polycystic Ovary Syndrome.” Trends in Molecular Medicine 12 (7): 324–332.
33. Li, L., H. Baek, H. Ahn, et al. 2022. “Long-Term Impact of Polycystic Ovary Syndrome on Health and Quality of Life.” Endocrinology and Metabolism 37 (4): 641–652.
34. Tomlinson, J., K. Pinkney, R. Adams, et al. 2020. “The Multifaceted Role of Lifestyle Modification in Polycystic Ovary Syndrome.” Nature Reviews Endocrinology 16: 135–146.
35. Barber, T.M., K. Hanson, N.J. Weickert, and S. Franks. 2018. “Obesity and Polycystic Ovary Syndrome.” Clinical Endocrinology 89: 535–549.
36. Saxena, P., P. Prakash, and N. Nigam. 2019. “Effect of Exercise and Diet on PCOS: A Systematic Review.” Journal of Obstetrics and Gynecology of India 69: 479–486.
37. Kaur, M., and S. Krishan. 2021. “Prevalence of Polycystic Ovary Syndrome among Female Medical Students.” Journal of Family Medicine and Primary Care 10: 1374– 1379.
38. Moran, L.J., H.J. Teede, and R.J. Norman. 2011. “Lifestyle Changes in Women with Polycystic Ovary Syndrome.” Human Reproduction Update 17 (2): 171–183.
39. Wei, D., X. Zhang, L. Geng, et al. 2020. “The Impact of Inositol Supplementation in Women with PCOS: A Meta-Analysis.” Gynecological Endocrinology 36 (5): 370– 377.
40. Unfer, V., L. Carlomagno, E. Dante, and S. Facchinetti. 2012. “Effects of Myo- Inositol in Women with PCOS: A Systematic Review of Randomized Controlled Trials.” Gynecological Endocrinology 28: 509–515.
41. Zhang, J., Y. Qi, and J. Ren. 2019. “Berberine in the Treatment of Polycystic Ovary Syndrome: A Systematic Review.” Evidence-Based Complementary and Alternative Medicine 2019: 1–10.
42. Duleba, A.J., and R.J. Dokras. 2012. “Is There a Role for Antiandrogens in the Treatment of PCOS?” Human Reproduction 27: 297–301.
43. Bednarska, S., and B. Siejka. 2017. “The Pathogenesis and Treatment of PCOS: What’s New?” Advances in Clinical and Experimental Medicine 26 (2): 359–367.
44. Zangeneh, F.Z., and S. Jafarabadi. 2015. “The Role of Genetics in the Etiology of PCOS.” International Journal of Endocrinology and Metabolism 13 (3): e13810.
45. Karasu, A.F., and M. Erel. 2020. “Polycystic Ovary Syndrome: Current Therapeutic Approaches and Future Perspectives.” Experimental and Clinical Endocrinology & Diabetes 128: 451–460.
46. Zhang, X., Y. Liu, H. He, and S. Zhang. 2021. “Role of Gut Microbiota in PCOS and Its Potential Therapeutic Implications.” Journal of Ovarian Research 14: 91.
47. Patel, S. 2018. “Role of Inflammation in Polycystic Ovary Syndrome.” International Journal of Molecular Sciences 19 (10): 3469.
48. Ibáñez, L., F. de Zegher, and C. Potau. 2005. “Anovulation in Adolescent Girls.”
49. Human Reproduction Update 11: 175–183.
50. Dokras, A. 2016. “Mood and Anxiety Disorders in Women with PCOS.” Steroids 78: 291–296.
51. Cooney, L.G., M. Milman, and A. Dokras. 2017. “Depression and Anxiety in Women with PCOS: A Narrative Review.” Therapeutic Advances in Reproductive Health 11: 173–183.
52. Jones, G.L., B.C. Hall, M.J. Balen, et al. 2008. “Health-Related Quality of Life in
53. PCOS: A Systematic Review.” Human Reproduction Update 14: 15–25.
54. Rojas, J., A. Chávez-Castillo, J. Bermúdez, et al. 2014. “Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome.” Steroids 89: 42–45.
55. Gambineri, A., R. Pelusi, U. Vicennati, et al. 2002. “Obesity and the Polycystic Ovary Syndrome.” International Journal of Obesity 26: 883–896.
56. Hoeger, K.M., and R.S. Legro. 2008. “Treatment of Infertility in Women with Polycystic Ovary Syndrome.” Current Opinion in Endocrinology, Diabetes and Obesity 15: 490–495.
57. Yildiz, B.O. 2008. “Obesity, Hyperandrogenism, and PCOS.” Obstetrics and Gynecology Clinics of North America 33: 229–240.
58. De Leo, V., S. Musacchio, M. Cappelli, et al. 2016. “Genetic, Hormonal and Metabolic Aspects of PCOS.” Reproductive Biology and Endocrinology 14: 23.
59. Dashti, S.G., A. Akhgar, and H. Faraji. 2017. “Prevalence of PCOS among Iranian Women.” Iranian Journal of Reproductive Medicine 15: 457–462.
60. Rashidi, B.H., F. Tehrani, and P. Mahdavi. 2021. “Effect of Lifestyle Intervention on PCOS Symptoms in Iranian Women.” Journal of Endocrinological Investigation 44: 1051–1059.
61. Ganie, M.A., M. Kalra, A. Shah, et al. 2020. “PCOS Guidelines in India: Recommendations for Clinical Practice.” Indian Journal of Endocrinology and Metabolism 24 (1): 1–10.
62. Sirmans, S.M., and K.A. Pate. 2013. “Epidemiology of PCOS.” Clinical Epidemiology 6: 1–13.
63. Wolf, W.M., S.G. Wattick, A. Kinkade, and M.A. Olfert. 2018. “Prevalence of PCOS Risk Factors among U.S. College Students.” American Journal of Lifestyle Medicine 12 (5): 356–364.
64. Reddy, K.V., and V. Dhole. 2019. “PCOS: A Major Health Concern in Indian Women.” Current Science 117 (3): 389–398.