Date of Award
Spring 2021
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Jodi Freeman, MMS, PA-C
Abstract
Abstract:
Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder found in women of reproductive age that often causes infertility. The first-line treatment for infertility in anovulatory PCOS patients is ovulation induction. In vitro fertilization (IVF) is a third line treatment often used as a last resort. PCOS patients have higher failure risks of first- and second-line medications. Therefore, this review analyzes if adverse pregnancy outcomes (O) are reduced more with IVF (I) versus using letrozole for ovulation induction (C) in women aged 20-30 struggling with infertility due to anovulatory PCOS (P).
Methods: A literature search on Pubmed and EBSCOhost was completed in November 2019. A total of 16 articles were chosen due to various inclusion and exclusion criteria.
Results: Letrozole had significantly increased pregnancy rates compared to clomiphene citrate in two studies. Two other studies compared age and IVF outcomes, finding significant decreases in pregnancy outcomes with increasing age. The studies directly comparing IVF and ovulation induction found comparable pregnancy outcomes.
Discussion: The studies chosen consisted of surveys and randomized controlled trials addressing various outcome measurements of ovulation induction and IVF. The age range of IVF participants included larger groups of women over 30 while ovulation induction included even groups of younger and older women. Most studies separated BMI into groups or excluded participants over a certain range. Many studies had poor blinding techniques but had appropriate inclusion/exclusion criteria and meaningful statistical analyses of their data.
Conclusion: More research must be conducted to directly compare IVF and LE with even groups of participants under 30. The outcome measurements of IVF are comparable to ovulation induction even with the impact of age on infertility. More in-depth studies on IVF in patients with PCOS must be completed to offer these patients the safest method with the best pregnancy outcomes.
Recommended Citation
Salay, Amanda, "The Efficacy of In Vitro Fertilization in Treating Infertility due to Anovulatory PCOS in Comparison to Ovulation Induction via Letrozole" (2021). Capstone Showcase. 13.
https://scholarworks.arcadia.edu/showcase/2021/pa/13
Included in
Endocrinology, Diabetes, and Metabolism Commons, Medical Pathology Commons, Medical Pharmacology Commons, Obstetrics and Gynecology Commons
The Efficacy of In Vitro Fertilization in Treating Infertility due to Anovulatory PCOS in Comparison to Ovulation Induction via Letrozole
Abstract:
Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder found in women of reproductive age that often causes infertility. The first-line treatment for infertility in anovulatory PCOS patients is ovulation induction. In vitro fertilization (IVF) is a third line treatment often used as a last resort. PCOS patients have higher failure risks of first- and second-line medications. Therefore, this review analyzes if adverse pregnancy outcomes (O) are reduced more with IVF (I) versus using letrozole for ovulation induction (C) in women aged 20-30 struggling with infertility due to anovulatory PCOS (P).
Methods: A literature search on Pubmed and EBSCOhost was completed in November 2019. A total of 16 articles were chosen due to various inclusion and exclusion criteria.
Results: Letrozole had significantly increased pregnancy rates compared to clomiphene citrate in two studies. Two other studies compared age and IVF outcomes, finding significant decreases in pregnancy outcomes with increasing age. The studies directly comparing IVF and ovulation induction found comparable pregnancy outcomes.
Discussion: The studies chosen consisted of surveys and randomized controlled trials addressing various outcome measurements of ovulation induction and IVF. The age range of IVF participants included larger groups of women over 30 while ovulation induction included even groups of younger and older women. Most studies separated BMI into groups or excluded participants over a certain range. Many studies had poor blinding techniques but had appropriate inclusion/exclusion criteria and meaningful statistical analyses of their data.
Conclusion: More research must be conducted to directly compare IVF and LE with even groups of participants under 30. The outcome measurements of IVF are comparable to ovulation induction even with the impact of age on infertility. More in-depth studies on IVF in patients with PCOS must be completed to offer these patients the safest method with the best pregnancy outcomes.