A randomized study of dexamethasone in ovulation induction with clomiphene citrate

Daly, Douglas C.; Walters, Clifford A.; Soto-Albors, Carlos E.; Tohan, Narendra; Riddick, Daniel H.

doi:10.1016/s0015-0282(16)47896-9

Cited by 129 publications

(34 citation statements)

References 12 publications

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“…24,25 The combination of reduced androgen concentrations and augmented FSH secretion may induce responsiveness of drugs in a previous nonresponder. It is not only effective in hyperandrogenic women 6,7,24,26 but also has been shown to be effective in CC resistant women with normal levels of DHEAS. 6,25 In our series we also found effective result by using lowdose glucocorticoid therapy even with normal androgen levels.…”

Section: Discussionmentioning

confidence: 99%

“…It is not only effective in hyperandrogenic women 6,7,24,26 but also has been shown to be effective in CC resistant women with normal levels of DHEAS. 6,25 In our series we also found effective result by using lowdose glucocorticoid therapy even with normal androgen levels. Eighty percent patients ovulated after administration of lowdose glucocorticoid along with letrozole therapy.…”

Section: Discussionmentioning

confidence: 99%

“…A number of authors shown that effectiveness of clomiphene citrate were improved when the circulating androgen levels were suppressed with glucocorticoids. 6,7,[24][25][26][27] Even in hyperandrogenic women unresponsive to clomiphene citrate, pretreatment with glucocorticoids to suppress androgen levels results in establishment of an ovulatory response to clomiphene citrate. 26 Same happened in our study though initial ovulation inducing agent was letrozole instead of clomiphene citrate.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of action presumably involves a reduction in adrenal androgen secretion which may reduce total circulating androgen levels by as much as 40%. [5][6][7] As a result of reduction of androgen to some extent folliculogenesis might be improved. So aim of this study was to explore the efficacy of glucocorticoids in folliculogenesis by reducing androgen to some extent in PCOS.…”

Section: Introductionmentioning

confidence: 99%

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Beneficial Effects of Addition of Glucocorticoid during Induction of Ovulation by Letrozole in Polycystic Ovarian Syndrome

Begum¹,

Siddiqui²,

Baby³

et al. 2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: The aim of the study was to explore the efficacy of glucocorticoid in folliculogenesis and ovulation during induction of ovulation by letrozole in polycystic ovarian syndrome (PCOS). Materials and methods:This experimental study was conducted in Dhaka Medical College and Hospital and Infertility Care and Research Centre (ICRC) Dhaka, Bangladesh. Two hundred and eighty infertile patients with PCOS, who failed to ovulate by letrozole 10 mg/day for 5 days were the target population of this study. The patients received glucocorticoid (Dexamethasone) 0.5 mg every alternate day from D2 of the cycle till D10 along with same dose of letrozole in subsequent cycles. Only letrozole-treated cycles were taken as control and letrozole plus glucocorticoid-treated cycles were taken as experimental. Monitoring was done by transvaginal ultrasonography. Six ovulatory cycles were observed for pregnancy. Main outcome measures were ovulation and pregnancy.Results: Baseline characteristics were similar as same patients were taken as control and experimental. One hundred and eighty-two (65%) patients were ovulated and 93 (33.21%) patients got pregnant after addition of glucocorticoid. Conclusion:In PCOS addition of glucocorticoid during induction of ovulation appears to cause significant improvement in folliculogenesis, ovulation and pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beneficial Effects of Addition of Glucocorticoid during Induction of Ovulation by Letrozole in Polycystic Ovarian Syndrome

Begum¹,

Siddiqui²,

Baby³

et al. 2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Approximately 50±70% of PCOS patients have excessive adrenal androgen levels and treatment with glucocorticoids only has been reported to improve menstrual regularity in 30±66% of oligo-ovulatory patients (13). Further, corticosteroid suppression may enhance the ovulatory response to clomiphene citrate, particularly in those patients with higher DHEAS levels (14). Although no differences were found for basal levels and maximum net increases of DHEA and DHEAS among three groups, higher Dandrostenedione in response to ACTH stimulation in PCOS-BO patients suggests its adrenal origin.…”

Section: Discussionmentioning

confidence: 99%

Ovarian-adrenal cross-talk in polycystic ovary syndrome: evidence from wedge resection

Shan-ying²,

Sallinen³

et al. 2000

European Journal of Endocrinology

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Objective: To determine whether the ovary in¯uences adrenal androgen secretion in women with polycystic ovary syndrome (PCOS). Design: Six PCOS-affected patients with clomiphene resistance and gonadotrophin hyperresponsivity, and six controls with regular ovulatory cycles, matched for age and body mass index. Methods: Bilateral ovarian wedge resection was performed to induce ovulation surgically for these refractory women with PCOS. The adrenal androgen secretions were evaluated in PCOS patients before and again 6 months after this surgery, and in the controls, using an ACTH stimulation test (0.25 mg synthetic ACTH(1±24)). Results: Biochemically, basal levels and the maximum net increases (D) of 17-hydroxyprogesterone (17-OHP) and androstenedione, D17-OHP/Dprogesterone and Dandrostenedione/D17-OHP ratios in response to exogenous ACTH were signi®cantly higher in PCOS patients before operation than those of controls. This purely ovarian surgery in women with PCOS was found to signi®cantly reduce their basal androstenedione, testosterone and LH levels, insulin/glucose ratio, and post-corticotrophic D17-OHP, Dandrostenedione, D17-OHP/Dprogesterone and Dandrostenedione/D17-OHP, without obvious changes in FSH, oestradiol, sex hormone-binding globulin, Ddehydroepiandrosterone, Ddehydroepiandrosterone sulphate, Daldosterone and Dcortisol values. Conclusions: Ovarian hyperandrogenicity from polycystic ovary may contribute to the enhanced adrenal P450c17a activity and subsequent D 4 androgen reserve revealed by the pharmacological corticotrophin stimulation in our special PCOS cases.

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Polycystic Ovary Syndrome and Infertility

Willenberg¹,

Bahlo²,

Schott³

2007

JAMA

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A randomized study of dexamethasone in ovulation induction with clomiphene citrate

Cited by 129 publications

References 12 publications

Beneficial Effects of Addition of Glucocorticoid during Induction of Ovulation by Letrozole in Polycystic Ovarian Syndrome

Beneficial Effects of Addition of Glucocorticoid during Induction of Ovulation by Letrozole in Polycystic Ovarian Syndrome

Ovarian-adrenal cross-talk in polycystic ovary syndrome: evidence from wedge resection

Polycystic Ovary Syndrome and Infertility

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