Induction of ovulation in infertile women with hyperandrogenism and insulin resistance

The polycystic ovary syndrome is a common cause of anovulatory infertility. Women with severe insulin resistance are a unique subset of polycystic ova ry syndrome. The syndrome of hyperandrogenism, insulin resistance, and acan thosis nigricans (HAIR-AN syndrome) is one presentation of the insulin-resi stant subset of polycystic ovary syndrome. Insulin resistance and hyperandr ogenism are caused by genetic and environmental factors. In women with anov ulatory infertility caused by hyperandrogenism and insulin resistance, clom iphene citrate treatment often fails to result in pregnancy. For these wome n, weight loss and insulin sensitizers can be effective methods of inducing ovulation and pregnancy and may reduce the number of clomiphene-resistant women with polycystic ovary syndrome who are treated with gonadotropins, ov arian surgery, or in vitro fertilization-embryo transfer.