Common fertility treatment step may have opposite effect

A common first step of fertility treatment for women with polycystic ovary syndrome may actually decrease the odds of conception, according to National Institutes of Health research on which Penn State Hershey’s Dr. Richard Legro was a co-investigator.

Women with polycystic ovary syndrome, also known as PCOS, often have trouble getting pregnant and do not ovulate regularly. The ovaries produce too much of a hormone called androgen that leads to irregular menstrual cycles and also to overgrowth of the lining of the uterus.

“Progestin has been used as a first step of fertility treatment to shed the uterine lining, which is often thick and dysfunctional,” said Legro, professor of obstetrics and gynecology, and public health sciences. “Before women receive drugs to stimulate egg release, the progestin was given to start a new uterine lining.”

Women in the study, however, were four times more likely to conceive without receiving progestin before receiving fertility drugs (with no effect on ovulation rates). While 20 percent of women who did not receive progestin gave birth, only 5 percent who received the hormone did.

Researchers used data from a 2007 study that had compared two fertility treatments for women with PCOS. They analyzed the effectiveness of ovulation induction combined with progestin treatment to ovulation induction alone.

“This is obviously a startling finding, and one that needs further study to verify the cause and the extent of this potential adverse effect on treatment,” said Legro, who hopes soon to proceed with further studies in this area. The study was published online in the journal Obstetrics and Gynecology.

To read the full National Institutes of Health press release, visit www.nih.gov/news/health/may2012/nichd-24.htm.

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Last Updated June 07, 2012