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Monofollicular Stimulation in PCOS Patients

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Abstract

Polycystic ovary syndrome (PCOS) is the major cause of anovulatory infertility that affects up to 5–10 % of reproductive-age women. Very few studies have focused on monofollicular stimulation in vitro fertilization (IVF) in PCOS patients till now. The first-line medical ovulation induction therapy to improve fertility outcomes is Clomiphene citrate (CC); the recommended starting dose is 50 mg/day. Letrozole has been shown to have good ovulation rate in CC-resistant PCOS women; 5 mg/day showed an optimal result, with high monofolliculogenesis occurrence in PCOS women. When PCOS patients are undergoing IVF treatment, many of these women exhibit exaggerated response, resulting in an increased risk of ovarian hyperstimulation syndrome (OHSS) and multiple gestations. The transfer of frozen-thawed embryos has important implications for the management of women undergoing ovarian hyperstimulation for IVF. Frozen embryo transfer (FET) endometrial preparation by Letrozole combined with human menopausal gonadotropin (hMG) in PCOS is a novel protocol giving us optimal clinical results. The protocol of Letrozole combined with hMG has the potential to be the first-line treatment option for ovulation induction in PCOS women, while its use in ovarian stimulation for IVF deserves further study.

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  1. Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Zhizaoju Road 639, Huangpu District, Shanghai, 200011, People’s Republic of China

    Yanping Kuang MD, Qingqing Hong MD & Qiuju Chen MD

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  1. Yanping Kuang MD
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  2. Qingqing Hong MD
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  3. Qiuju Chen MD
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Correspondence to Yanping Kuang MD .

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  1. 1st floor, Rotunda-CHR 36, Mumbai, India

    Gautam N. Allahbadia

  2. Department of Assisted Reproduction, Obstetrics and Gynecology, ICI – Instituto Canario de Infertilidad , Las Palmas de Gran Canaria, Spain

    Markus Nitzschke

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Kuang, Y., Hong, Q., Chen, Q. (2015). Monofollicular Stimulation in PCOS Patients. In: Allahbadia, G., Nitzschke, M. (eds) Minimal Stimulation and Natural Cycle In Vitro Fertilization. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1118-1_8

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