This multicenter, randomized trial compared the effects of clomiphene citrate plus placebo, metformin plus placebo, and combination therapy in infertile women with the polycystic ovary syndrome. The ...rate of live birth was significantly higher with clomiphene than with metformin; there was no significant difference between the rates with combination therapy and with clomiphene alone. Multiple birth was a complication associated with clomiphene but was infrequent. These data support the use of clomiphene over metformin for the treatment of infertility in women with the polycystic ovary syndrome.
In infertile women with the polycystic ovary syndrome, the rate of live birth was significantly higher with clomiphene than with metformin.
The polycystic ovary syndrome affects 7 to 8% of women
1
and may be the most common cause of female infertility.
2
Anovulation,
2
early pregnancy loss,
3
and later pregnancy complications
4
have all been implicated in the low fecundity of women with this disorder. Obesity is also common in such women,
5
and this condition alone appears to have an adverse effect on reproduction.
6
,
7
The cause of the polycystic ovary syndrome is poorly understood, and both the diagnosis and treatment of the disorder are controversial.
5
,
8
,
9
Women with this syndrome have hyperandrogenism,
10
morphologic changes in the ovary (polycystic),
10
inappropriate gonadotropin secretion (elevated . . .
Legal considerations in reproductive medicine Crockin, Susan L.; Schlaff, William D.
Fertility and sterility,
February 2021, 2021-Feb, 2021-02-00, 20210201, Letnik:
115, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Legal issues affect reproductive medical practice throughout the entire world. The breadth and depth of this interrelationship extend far beyond the scope of one series of articles in Views and ...Reviews. Given this limitation, we have chosen to present five topics, all different, but illustrative of key concepts that influence our practice of reproductive medicine. Our hope is that this “medical-legal sampler” will both inform and provoke thoughtful consideration of the ways we can best and most responsibly practice and serve our patients.
This Views and Reviews explores existing data regarding the impact of nutrition, supplements, and lifestyle changes as they relate to weight on the fertility of both men and women. Challenges and ...shortcomings in developing and performing well-designed studies of nutrition and fertility are reviewed in these five papers, and the best evidence is presented. Recommendations are made based on the data, such as they are. It appears that folic acid supplementation above the level used by women to reduce the risk of neural tube defects may be of value in producing favorable pregnancy outcomes. Certain polyunsaturated fatty acids may have a beneficial effect on fertility, and a Mediterranean diet may prove advantageous in both men and women. Data do not consistently support a beneficial effect of vitamin D on reproduction, and caffeine use has not been shown to have a deleterious effect. Alcohol use may negatively impact reproductive success, and smoking appears to have a clearly negative impact in both men and women. Present data consistently show that obesity is associated with reduced reproductive efficiency in both women and men, but the data do not confirm that weight loss proximate to attempts at conception will reverse this effect. We would do well to appreciate that the ongoing state of being obese appears to be more relevant to reproduction than changing the obese state.
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