Gynecology 2027

Ovulation induction remains a cornerstone of reproductive medicine and is the first-line therapeutic approach for many women with anovulatory infertility, particularly those affected by polycystic ovary syndrome (PCOS). The transition from clomiphene citrate to aromatase inhibitors, especially letrozole, has substantially changed clinical practice. At the same time, a deeper understanding of the interactions between the hypothalamic–pituitary–ovarian axis, insulin metabolism, ovarian steroidogenesis and the follicular microenvironment is opening new opportunities for individualized treatment. This lecture critically reviews current therapeutic strategies, including letrozole, clomiphene citrate, metformin, gonadotropins and assisted reproductive technologies, focusing on reproductive effectiveness, safety, prevention of multiple pregnancy and ovarian hyperstimulation syndrome. Emerging approaches are also discussed, including GLP-1 receptor agonists for preconception metabolic optimization, neuroendocrine modulation through kisspeptin and neurokinin B pathways, predictive biomarkers, artificial intelligence and personalized ovarian stimulation. The central argument is that the future of ovulation induction will not depend solely on discovering more potent drugs. Instead, it will require identifying the most appropriate treatment for each individual patient, maximizing the probability of live birth while minimizing maternal and fetal risks.

Updating soon...