Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility

Ellakwa, Hamid; Sanad, Zakaria F; Hamza, H.A.; Emara, Mohamed; Elsayed, Mohamed A.

doi:10.1016/j.ijgo.2015.09.008

Cited by 31 publications

(36 citation statements)

References 19 publications

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“…The baseline characteristics were compared between the responders and the non‐responders in order to identify the clinical predictors of the response to ICT. Although high levels of a Body Mass Index, LH, LH/FSH ratio, testosterone, and the Homeostatic Model Assessment of Insulin Resistance were reported to be associated with CC resistance, this study found no difference in these factors between groups. Further studies are needed to identify the predictors of the response to ICT.…”

Section: Discussioncontrasting

confidence: 86%

Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment

Takasaki

Tamura

Okada‐Hayashi

et al. 2018

Reprod Medicine & Biology

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PurposeClomiphene citrate (CC) has been used as a first‐line treatment for anovulatory polycystic ovary syndrome (PCOS). However, some patients with PCOS are resistant to standard CC treatment. In this study, a new CC treatment protocol was developed, named “intermittent CC treatment” (ICT) and its efficacy was investigated on the induction of follicular growth in patients with PCOS who were resistant to standard CC treatment.MethodsOf the 42 patients with PCOS who were resistant to standard CC treatment (50 mg/day, 5 days), 26 underwent ICT. They were given 100 mg/day of CC for 5 days from the next menstrual cycle day (MCD) 5 (first CC). If follicular growth was not observed on MCD 14, they were given 100 mg/day of CC for 5 days (MCD 14‐MCD 18) (second CC). If follicular growth still was not observed on MCD 23, they were treated with CC again in the same way (third CC).ResultsThe first CC, second CC, and third CC were effective for 3/26 (11.5%) patients, 12/23 (52.2%) patients, and 6/11 (54.5%) patients, respectively. In total, ICT was effective for 21/26 (80.8%) patients with CC‐resistant PCOS.ConclusionThus, ICT is a useful treatment and could be an alternative to gonadotropin therapy for patients with CC‐resistant PCOS.

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Section: Discussioncontrasting

confidence: 86%

Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment

Takasaki

Tamura

Okada‐Hayashi

et al. 2018

Reprod Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…Elevated of testosterone [14] and IR [15] have been reported as predictive factors in CC-resistant PCOS. Ellakwa et al [16] promoted that a combination of patient amenorrhea, BMI, total testosterone, AMH, ovarian volume, ovarian stromal artery pulsatility index, and visceral fat area could be used to predict CC treatment response, but thyroid function was not referred in their study. Ott et al [17] have found PCOS patients with elevated antiTPO levels were at an increased risk for CC resistance (odds ratio, 7.7).…”

Section: Introductionmentioning

confidence: 99%

Subclinical hypothyroidism is associated with metabolic syndrome and clomiphene citrate resistance in women with polycystic ovary syndrome

Xia

et al. 2016

Gynecological Endocrinology

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“…For ovulation disorders caused by PCOS, CC and LE are used currently for ovulation induction. At present, CC remains the first-line drug for ovulation induction, with ovulation rates of 75% to 80%,9 but recent studies have shown that a considerable proportion of patients did not get desirable pregnancy outcomes after CC treatment 10,11. In the normal ovulation process, estrogen and progesterone play obvious regulatory roles, and CC has anti-estrogenic effects, but its exact mechanism has not been fully clarified yet 12.…”

Section: Discussionmentioning

confidence: 99%

Effects of letrozole in combination with low-dose intramuscularinjection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome

et al. 2016

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Objective:To explore the effects of letrozole (LE) in combination with low-dose intramuscular injection of human menopausal gonadotropin (HMG) on the ovulation induction and pregnancy of patients with polycystic ovary syndrome (PCOS).Methods:A total of 156 patients with PCOS infertility were randomly divided into an LE group, a clomiphene citrate (CC) group and an LE + HMG group (n= 52). LE and CC were orally taken according to the prescribed dosage on the 3rd-5th days of menstruation respectively, and 75 IU HMG was given through intramuscular injection. The ovulation induction parameters and pregnancy outcomes were observed.Results:The number of ovulation cycle of LE + HMG group was significantly higher than that of LE group (χ2=8.451, P<0.001). After injection of human chorionic gonadotropin, both endometrial thickness and number of mature follicles of LE + HMG group were significantly higher than those of other two groups (P<0.001), and the daily estradiol (E2) level was also higher (q=4.531, P<0.05). The pregnancy rate of LE + HMG group was 55.7%, which exceeded those of other two groups (compared to LE group, χ2=4.012, P<0.05). In LE + HMG group, the average medication cycle of clinically pregnant patients was (2.9 ± 0.3) weeks, which was significantly shorter than those of CC and LE groups (F=17.241, P<0.001).Conclusion:The regimen using LE in combination with low-dose intramuscular injection of HMG has satisfactory therapeutic effects on ovulation induction, short medication cycle and high clinical pregnancy rate, which is promising for treating patients with PCOS infertility.

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Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility

Cited by 31 publications

References 19 publications

Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment

Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment

Subclinical hypothyroidism is associated with metabolic syndrome and clomiphene citrate resistance in women with polycystic ovary syndrome

Effects of letrozole in combination with low-dose intramuscularinjection of human menopausal gonadotropin on ovulation and pregnancy of 156 patients with polycystic ovary syndrome

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