TY - JOUR
T1 - Fertility management in the PCOS population
T2 - Results of a web-based survey at IVF-worldwide.com
AU - Brezina, Paul R.
AU - Mensah, Virginia
AU - Balen, Adam
AU - Leong, Milton
AU - Weissman, Ariel
AU - Zhao, Yulian
AU - Shoham, Zeev
PY - 2013/9
Y1 - 2013/9
N2 - Purpose: To identify the leading treatment strategies for infertile women with PCOS on an international scale. Methods: A retrospective evaluation using the results of a web-based survey, (IVF-Worldwide (www.IVF-worldwide.com), posted from 1 to 30 September 2010 was performed. Binomial confidence intervals for proportions were calculated by the modified Wald method with significance defined as P < 0.05 using a DataStar software package (DataStar, Waltham, MA, USA). Incomplete surveys were excluded from the analysis. Results: The results from 262 centers in 68 nations were obtained. Clomiphene citrate was the clear first choice, 68 %, for PCOS treatment in the respondent group. Eighty-eight percent of respondents utilized ultrasound follicular monitoring when conducting ovulation induction with oral medications. A significant (p < 0.05) proportion of respondents (66 %) did use some BMI cutoff beyond which IVF treatment was not offered. The preferred IVF protocols for PCOS patients were gonadotropin releasing hormone (GnRH) antagonist, 46 %, and GnRH agonist, 51 %. There was heterogeneity of responses observed regarding the management of a patient at very high risk of OHSS. Conclusions: While some advances, such as the use of GnRH antagonist regimen in IVF cycles, were relatively underutilized, the survey gives an unfiltered snapshot at the practice patterns of a large number of clinics. Results from this survey may be used by researchers and professional organizations to improve the clinical care of PCOS women suffering with infertility.
AB - Purpose: To identify the leading treatment strategies for infertile women with PCOS on an international scale. Methods: A retrospective evaluation using the results of a web-based survey, (IVF-Worldwide (www.IVF-worldwide.com), posted from 1 to 30 September 2010 was performed. Binomial confidence intervals for proportions were calculated by the modified Wald method with significance defined as P < 0.05 using a DataStar software package (DataStar, Waltham, MA, USA). Incomplete surveys were excluded from the analysis. Results: The results from 262 centers in 68 nations were obtained. Clomiphene citrate was the clear first choice, 68 %, for PCOS treatment in the respondent group. Eighty-eight percent of respondents utilized ultrasound follicular monitoring when conducting ovulation induction with oral medications. A significant (p < 0.05) proportion of respondents (66 %) did use some BMI cutoff beyond which IVF treatment was not offered. The preferred IVF protocols for PCOS patients were gonadotropin releasing hormone (GnRH) antagonist, 46 %, and GnRH agonist, 51 %. There was heterogeneity of responses observed regarding the management of a patient at very high risk of OHSS. Conclusions: While some advances, such as the use of GnRH antagonist regimen in IVF cycles, were relatively underutilized, the survey gives an unfiltered snapshot at the practice patterns of a large number of clinics. Results from this survey may be used by researchers and professional organizations to improve the clinical care of PCOS women suffering with infertility.
KW - IVF
KW - Infertility
KW - PCOS
KW - Survey
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84886376404&partnerID=8YFLogxK
U2 - 10.1007/s10815-013-0069-z
DO - 10.1007/s10815-013-0069-z
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C2 - 23897006
AN - SCOPUS:84886376404
SN - 1058-0468
VL - 30
SP - 1169
EP - 1174
JO - Journal of Assisted Reproduction and Genetics
JF - Journal of Assisted Reproduction and Genetics
IS - 9
ER -