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Date of Award

Spring 2023

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Lisa Akselrad PA-C

Abstract

Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in women of reproductive age and many of those diagnosed with PCOS struggle with anovulatory infertility. Clomiphene citrate and other medications are often the first line treatment for anovulatory infertility but more invasive options such as assisted reproductive technologies (ART) are available if medication fails. ART can include intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF). Even when an individual chooses to undergo these more invasive techniques in an attempt to get pregnant, it is not always successful. Therefore, this article aims to focus on if there are any additional benefits of using adjuvant treatments in women who are diagnosed with PCOS and are undergoing ART due to infertility issues. This article focuses on the adjunct use of clomiphene citrate, inositol’s (myo-inositol and d-chiro-inositol), metformin, vitamin D, and melatonin. Additionally, the primary outcomes of interest are the improvement in the quality of oocytes and chemical or clinical pregnancy rates. Not all of the included studies have these two as primary outcomes but were still included due to the evidence that was provided.

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Adjuvant Treatment in Women with Polycystic Ovarian Syndrome Undergoing Assisted Reproductive Technologies

Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in women of reproductive age and many of those diagnosed with PCOS struggle with anovulatory infertility. Clomiphene citrate and other medications are often the first line treatment for anovulatory infertility but more invasive options such as assisted reproductive technologies (ART) are available if medication fails. ART can include intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF). Even when an individual chooses to undergo these more invasive techniques in an attempt to get pregnant, it is not always successful. Therefore, this article aims to focus on if there are any additional benefits of using adjuvant treatments in women who are diagnosed with PCOS and are undergoing ART due to infertility issues. This article focuses on the adjunct use of clomiphene citrate, inositol’s (myo-inositol and d-chiro-inositol), metformin, vitamin D, and melatonin. Additionally, the primary outcomes of interest are the improvement in the quality of oocytes and chemical or clinical pregnancy rates. Not all of the included studies have these two as primary outcomes but were still included due to the evidence that was provided.