Preventive Strategies for Infertility in Women with PCOS, Endometriosis, Uterine Fibroids, and PID: A Systematic Review of Evidence-Based and Integrative Approaches

This systematic review evaluates current evidence on preventive interventions aimed at reducing infertility among women diagnosed with polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and pelvic inflammatory disease (PID). A comprehensive literature search identified ۱۵ studies, including randomized controlled trials and cohort studies, addressing lifestyle modifications, nutritional supplementation, pharmacological treatments, and surgical approaches. Lifestyle interventions such as diet and exercise significantly improved ovulation rates and menstrual regularity in PCOS patients by mitigating insulin resistance and promoting hormonal balance. Nutritional supplements including inositol and vitamin D showed beneficial effects on ovarian function. In endometriosis, anti-inflammatory diets and omega-۳ fatty acid supplementation reduced inflammatory markers and enhanced natural conception rates, while NSAIDs effectively managed pain without directly improving fertility. Surgical myomectomy and medical therapies, including GnRH agonists, demonstrated efficacy in reducing uterine fibroid burden and improving reproductive outcomes. Vitamin D supplementation also emerged as a promising preventive strategy against fibroid progression. Early administration of broad-spectrum antibiotics in PID preserved tubal patency and prevented infertility. Despite heterogeneity among studies, integrated approaches combining lifestyle, nutritional, pharmacological, and surgical interventions are vital for fertility preservation in these populations. Further large-scale randomized trials are warranted to establish standardized protocols. These findings underscore the importance of personalized, multidisciplinary management to optimize reproductive health and quality of life in affected women.

کلیدواژه ها:

PCOS ، Endometriosis ، Uterine Fibroids ، PID ، infertility ، preventive strategies ، evidence-based approaches ، integrative approaches ، lifestyle interventions ، nutritional supplementation ، pharmacological treatments ، surgical approaches ، ovulation ، insulin resistance ، hormonal balance ، inflammatory diets ، omega-۳ fatty acid supplementation ، NSAIDs ، myomectomy ، GnRH agonists ، broad-spectrum antibiotics ، tubal patency ، reproductive health ، quality of life