Strategies for the use of insulin-sensitizing drugs to treat infertility in women with polycystic ovary syndrome

John E. Nestler*, Dale Stovall, Nausheen Akhter, Maria J. Iuorno, Daniela J. Jakubowicz

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

198 Scopus citations

Abstract

Objective: Insulin resistance and its compensatory hyperinsulinemia play a key pathogenic role in the infertility of the polycystic ovary syndrome. Numerous studies indicate that insulin-sensitizing drugs can be used to enhance spontaneous ovulation and the induction of ovulation in the syndrome. The aim of this review is to summarize the studies in which insulin-sensitizing drugs were used to increase ovulation rate or improve fertility in women with the PCOS and to translate the information into practical guidelines for the use of these drugs by reproductive endocrinologists. Design: Review and critique of studies in which an insulin-sensitizing drug was used to increase ovulation rate or improve infertility in women with the polycystic ovary syndrome. Main Outcome Measure(s): Ovulation rate and pregnancy rate. Result(s): Studies have demonstrated that insulin-sensitizing drugs can increase spontaneous ovulation, enhance the induction of ovulation with clomiphene citrate, and increase clinical pregnancy rates. Conclusion(s): An algorithmic approach is provided for the use of insulin-sensitizing drugs to treat the anovulation and infertility of women with the polycystic ovary syndrome.

Original languageEnglish (US)
Pages (from-to)209-215
Number of pages7
JournalFertility and Sterility
Volume77
Issue number2
DOIs
StatePublished - 2002

Keywords

  • Clomiphene
  • Infertility
  • Inositol
  • Metformin
  • Ovulation
  • Polycystic ovary syndrome
  • Thiazolidinedione

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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