Novel clomiphene protocol in polycystic ovarian syndrome: Hurst et al

Bates, G. Wright; Shomento, Stacy; McKnight, Katherine; McLean, Hope M.

doi:10.1016/j.ajog.2009.02.019

Cited by 2 publications

(1 citation statement)

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“…One such protocol involves starting clomiphene citrate at the typical 50 mg dose. If inadequate follicular growth is noted, the dose can be increased by 50 mg for another round of treatment, without an intervening menses, until ovulation is achieved or the maximal dose of 150 mg daily is used 74,75. A study that included this protocol demonstrated a significantly higher ovulation rate with the stair-step protocol (64% versus 22%) and a shortened time to ovulation (23–35 days versus 55–88 days) when compared with the traditional regimen.…”

Section: Oral Agentsmentioning

confidence: 99%

Optimal management of subfertility in polycystic ovary syndrome

Berger¹,

Bates²

2014

IJWH

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The purpose of this paper is to provide a stepwise approach to treating the infertility/subfertility associated with polycystic ovary syndrome. Defining polycystic ovary syndrome in a patient requires first investigating other possible causes for polycystic ovary morphology, acne, hirsutism, obesity, and the metabolic derangements that often accompany polycystic ovary syndrome. Beginning with lifestyle modification and use of metformin, the progressive inclusion of more intensive therapies for induction of ovulation is described. Second-line treatments are discussed and the new findings from a large multicenter trial are discussed in the context of evidence-based treatment strategies for first-line agents. Finally, monofollicular development as a treatment goal and in vitro fertilization are discussed for those with recalcitrant disease.

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Section: Oral Agentsmentioning

confidence: 99%

Optimal management of subfertility in polycystic ovary syndrome

Berger¹,

Bates²

2014

IJWH

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Extension of the clomiphene citrate stair-step protocol to gonadotropin treatment in women with clomiphene resistant polycystic ovarian syndrome

Horowitz

Levran

Weissman

2017

Gynecological Endocrinology

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Our objective was to evaluate the safety and efficacy of direct initiation of gonadotropin ovarian stimulation without prior withdrawal bleeding in anovulatory clomiphene citrate (CC) resistant polycystic ovarian syndrome (PCOS) patients. Eighteen PCOS patients underwent ovulation induction with CC using a stair-step regimen. Patients who failed to respond to the maximal dose of CC initiated gonadotropin stimulation without inducing withdrawal bleeding, using the chronic low dose regimen. The primary outcome measure was the time to ovulation from the beginning of CC treatment until the day of ovulatory trigger. This was compared with the time to ovulation calculated according to the traditional approach, which includes inducing progesterone withdrawal bleeding between each CC dose increment and before gonadotropin therapy. The time to ovulation in the study group was 67.0 ± 6.8 days. The estimated time to ovulation according to the traditional approach was approximately 110 days. The clinical pregnancy rate was 44% (8/18), and all pregnancies were singletons. One patient miscarried; hence the live birth rate was 38.9% (7/18). Direct initiation of gonadotropin therapy without prior induction of withdrawal bleeding in clomiphene resistant PCOS patients results in considerable reduction of the time to ovulation and is both safe and efficacious.

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Novel clomiphene protocol in polycystic ovarian syndrome: Hurst et al

Cited by 2 publications

References 0 publications

Optimal management of subfertility in polycystic ovary syndrome

Optimal management of subfertility in polycystic ovary syndrome

Extension of the clomiphene citrate stair-step protocol to gonadotropin treatment in women with clomiphene resistant polycystic ovarian syndrome

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