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Abstract
Before initiating treatment to induce ovulation in cases of PCOS, an appropriate evaluation
of the patient and her partner, based on individual considerations, is important to
optimize outcome. For obese patients with PCOS, weight-loss measures should be pursued
before pharmacologic treatment is initiated. For most patients, the pharmacologic
agent of choice to induce ovulation is clomiphene citrate, alone or in combination
with a glucocorticoid. Treatment with metformin, alone or in combination with clomiphene
citrate, may also be beneficial. For patients not responsive to clomiphene citrate,
injectable gonadotropin treatment is usually warranted, although, depending on individual
circumstances, laparoscopic ovarian drilling may be appropriate.