ABSTRACT
Anovulation is a relatively common cause for infertility accounting for about 25% of all cases, the treatment of which is highly successful. Ovulatory disorders could be due to either hypothalamic-pituitary ovarian axis dysfunction or other endocrine diseases. Hypothalamic-pituitary ovarian anovulation is further classified into three categories including hypogonadotrophic hypogonadism [World Health Organization (WHO) Group I], normogonadotrophic anovulation (WHO Group II), and hypergonadotrophic hypogonadism (premature ovarian failure, WHO Group III). Other endocrine causes of ovulatory disorders include hyperprolactinemia, thyroid disorders, and adrenal diseases such as Cushing’s syndrome and adult onset congenital adrenal hyperplasia (CAH). By far, the most common cause of anovulatory infertility is polycystic ovarian syndrome (PCOS) (WHO Group II), which affects about 6% to 8% of women of reproductive age and accounts for approximately 80% of all cases of anovulation. It refers to a heterogeneous group of disorders with a varied combination of clinical
SECTION III: DRUGS IN REPRODUCTIVE MEDICINE
(obesity, oligo/amenorrhea, and hirsutism), biochemical [elevated serum concentrations of luteinizing hormone (LH) and androgens], and ultrasonographic (bilaterally enlarged polycystic ovaries) features.
