Progress in ovarian stimulation

It is uncertain whether patients who do not ovulate but fail to conceive fo llowing CC therapy behave differently during gonadotropin therapy. However, if the infertile patient with PCOS is resistant to anti-estrogen therapy, gonatropin treatment administered through low dose protocols should be cons idered. As compared to conventional regimens, complication rates are reduce d despite similar efficacy. It should be recognized that patients with PCOS constitute a very heterogeneous group. Therapy outcome may benefit from im proved classification. The identification of clinical characteristics that identify those women with anovulation who are unlikely to respond to clomip hene would permit earlier use of gonadotropin therapy and potentially offer major health and economic benefits. Furthermore, if ovarian responsiveness to ovulation-induction therapy could be predicted for an individual patien t, it might be possible to devise regimens that reduced the risk of ovarian hyperstimulation and multiple pregnancy.