Clomiphene citrate mild stimulation improved follicular development outcomes in PCOS women with high luteinizing hormone and poor ovarian response: A case report

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a main cause of anovulatory infertility in women of reproductive age. About 30% to 50% of patients with PCOS has high serum basal luteinizing hormone (LH) levels, and almost 5% of PCOS women with high LH have poor ovarian response (POR). We reported a case of a PCOS woman with high basal LH levels who canceled due to POR during two consecutive controlled ovarian stimulation treatments, which was considered to be related to the suppression of LH levels during downregulation. Clomiphene citrate (CC) combined with human menopausal urinary gonadotropin (HMG) mild regimen did not affect LH levels and obtained good follicular development, providing a new treatment insight for patients with PCOS combined with POR. Patient concerns: A 28-year-old PCOS woman with high basal LH levels, underwent IVF assisted pregnancy treatment in our hospital, whom canceled due to POR during two traditional controlled ovulation induction program. Follicular development was finally achieved with CC milder protocol. Diagnosis: This patient with the diagnosis of PCOS was undergone IVF assisted pregnancy treatment in our hospital. Interventions: CC protocol supports the development of follicular. Outcomes: CC protocol resulted in better follicular development and high-quality embryos due to the continuous maintenance of an elevated LH levels. Conclusion: PCOS women with poor ovarian response required relatively higher LH to maintain the normal development of follicles.

Aberrant HPO Axis Alterations and Autoimmune Abnormalities in PCOS Patients with DOR: A Retrospective Analysis

“…This is due to increased amplitude and frequency of LH pulses [ 20 ]. A recent study has shown that approximately 30% to 50% of patients with polycystic ovary syndrome have high serum basal LH levels and nearly 5% of women with high LH polycystic ovary syndrome have poor ovarian response [ 54 ]. In DOR patients, due to the decrease in the number of follicles, the insufficient secretion of estrogen and progesterone, and the weakening of negative feedback, the pituitary gland will secrete more FSH, resulting in an increase of the FSH levels.…”

Live birth rate per fresh embryo transfer and cumulative live birth rate in patients with PCOS under the POSEIDON classification: a retrospective study

“…Although not a high proportion, some women with PCOS fulfill the POSEIDON group, particularly for Groups 1 and 2. However, there are limited data available regarding the pregnancy outcomes of women with PCOS classified as poor responders ( 17 , 18 ). There is no study to address LBR per fresh embryo transfer and CLBR per aspiration cycle for women with PCOS categorized as poor responders in fertility treatments.…”