Shuichi Iida,
Successful Pregnancy in Infertile Elderly Woman with Polycystic Ovarian Syndrome after Multiple Attempts of Ovarian Stimulation: A Case Report
Case Reports in Obstetrics Gynecology and Reproductive
2024
2674-5070
http://dx.doi.org/10.31487/j.CROGR.2024.01.01
https://www.sciencerepository.org/successful-pregnancy-in-infertile-elderly_CROGR-2024-1-101 
Abstract: Ovarian stimulation (OS) in infertile elderly women with polycystic ovary syndrome (PCOS) is challenging because of the high risk of ovarian hyperstimulation syndrome (OHSS) and the possibility of age-related poor response.
We present a case of an elderly woman with anovulation due to PCOS who achieved pregnancy in the sixth intrauterine insemination (IUI) combined with letrozole plus gonadotropin without any adverse effects since OS using the clomiphene citrate (CC) or gonadotropin was not effective. In the clinical course of this case, adequate follicular development was not achieved by OS using CC only, and severe OHSS arose using FSH only. The regular and adequate follicular development by using OS combined with letrozole plus gonadotropin could be conceived by repeated IUI. 
The OS method combined with letrozole plus gonadotropin was effective for elderly women with anovulation due to PCOS.Keywords: Polycystic Ovarian Syndrome (PCOS), Ovarian Stimulation (OS), Intrauterine Insemination (IUI), Letrozole, Ovarian Hyperstimulation Syndrome (OHSS)