Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome.

Abstract

PURPOSE:

The aim was to test a new protocol of luteal phase administration of clomiphene citrate (CC) for ovulation induction in women with polycystic ovary syndrome (PCOS).

METHODS:

This was a prospective, randomized, controlled trial. Two hundred and fifty-two women (cycles) with PCOS were utilized to create two groups. Patients in Group 1 (126 patients) received 100 mg of CC daily for 5 days starting on day 5 of menses, and patients in Group 2 (126 patients) received 100 mg of CC daily for 5 days starting the next day after finishing medroxyprogesterone acetate (MPA) (before withdrawal bleeding). The main outcome measures were the number of growing and mature follicles, serum E2 (in pg/mL), serum progesterone (in ng/mL) levels, endometrial thickness (in mm), pregnancy, and miscarriage rates.

RESULTS:

The total number of follicles and the number of follicles ≥14 mm during stimulation were significantly greater in Group 2. The endometrial thickness at the time of human chorionic gonadotrophin (hCG) administration was significantly greater in Group 2 as compared to Group 1 (7.84 ± 1.22 and 8.81 ± 0.9, respectively). Serum E2 levels were also significantly higher (p < 0.05) in Group 2 as compared to Group 1 (449.61 ± 243.45 vs. 666.09 ± 153.41 pg/mL). Pregnancy occurred in 13 patients (10.3 %) in Group 2 and in 11 patients (8.7 %) in Group 1. The difference was not statistically significant.

CONCLUSION:

Luteal phase administration of CC in patients with PCOS leads to increased follicular growth and endometrial thickness, which might result in a higher pregnancy rate.

• Authors: Ozlem Kosar, Gulnur Ozaksit, Mine Islimye Taskin
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 290 Issue 4 Pg. 771-5 (Oct 2014) ISSN: 1432-0711 [Electronic] Germany
• PMID: 24840109 (Publication Type: Journal Article, Randomized Controlled Trial, Retracted Publication)

Chemical References

• Fertility Agents, Female
• Clomiphene
• Progesterone
• Estradiol

Topics

• Adult
• Clomiphene (administration & dosage)
• Endometrium (diagnostic imaging)
• Estradiol (blood)
• Female
• Fertility Agents, Female (administration & dosage)
• Humans
• Luteal Phase
• Ovarian Follicle (diagnostic imaging)
• Ovulation Induction (methods)
• Polycystic Ovary Syndrome (drug therapy)
• Pregnancy
• Pregnancy Rate
• Progesterone (blood)
• Prospective Studies
• Ultrasonography