Page 123 - PCC07
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Consensus Algorithm – WHO 2016
Ovulation detected
No: proceed to OI if BMI satisfactory
Ovulation detected
No, or not pregnant
Balen et al, Human Reproduction Update 2016 Nov;22:687-708.
PCOS
Rotterdam Criteria
No: 2nd line therapy
Ovulation detected
Gonadotropins
or
CC + metformin
or
Laparoscopic ovarian diathermy
IVF – last resort
Ovulation detected
No
Yes: await natural conception.
If no pregnancy after 6‐9 cycles: IVF
Full fertility investigations, assessment IR
If overweight Lifestyle +/‐ Bariatric surgery
Clomiphene citrate (CC)
or
Letrozole
Yes: 6‐9 cycles
If not pregnant: IVF
Yes: 6 cycles
If not pregnant: IVF
Consensus Algorithm – WHO 2016
Ovulation detected
No: proceed to OI if BMI satisfactory
Ovulation detected
No, or not pregnant
Balen et al, Human Reproduction Update 2016 Nov;22:687-708.
PCOS
Rotterdam Criteria
Ovulation detected
Yes: await natural conception.
If no pregnancy after 6‐9 cycles: IVF
No
Full fertility investigations, assessment IR
If overweight Lifestyle +/‐ Bariatric surgery
Clomiphene citrate (CC)
or
Letrozole
Yes: 6‐9 cycles
If not pregnant: IVF
No: 2nd line therapy
Ovulation detected
Gonadotropins
or
CC + metformin
or
Laparoscopic ovarian diathermy
IVF – last resort
Yes: 6 cycles
If not pregnant: IVF
Page 116 of 196
PRECONGRESS COURSE 07 I BARCELONA, SPAIN – 1 JULY 2018 123
