Polycystic ovarian syndrome. Treatment of infertility patients

Polycystic ovarian syndrome (PCOS) has a prevalence of 3-5%. Its typical features include oligo-/amenorrhea combined with hyperandrogenemia or hyperandrogenism. Regarding differential diagnosis adrenal enzyme defects as well as Cushing's syndrome must be excluded. The oral glucose tolerance test with parallel insulin measurement is essential in daily clinical practice to evaluate insulin resistance. In cases of predominantly cosmetic problems without fertility problems, oral contraceptives can be used. In infertility patients suffering from PCOS the lean, oligomenorrheic patient can start directly with ovarian stimulation using clomiphene citrate. In all other patients, the option of metformin should be evaluated on an individual basis, and contraindications for metformin therapy must be excluded. Weight reduction and sports are essential components of the treatment concept, since they improve the conditions for becoming pregnant.