Study of the response of PCOS patients to clomiphene citrate based on hormonal Parameters and body mass index
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240466Keywords:
Anovulation, Body mass index, Clomiphene citrate response, Infertility, Hormonal correlation, Polycystic ovarian syndromeAbstract
Background: Our study aimed to evaluate the response of polycystic ovarian syndrome patients to clomiphene citrate based on hormonal parameters and body mass index.
Methods: It is a prospective observational study that was carried out on 48 women with PCOS-related infertility. They were treated with an incremental dose of clomiphene citrate starting with 50 mg/day to a maximum of 100 mg. The response was recorded as either the presence or absence of ovulation. Hormonal parameters such as serum FSH, LH, testosterone, fasting insulin, DHEA, prolactin, and body mass index (BMI) were evaluated. The correlation of each of these parameters in predicting non-responsiveness (failure to ovulate with 100 mg clomiphene) was calculated.
Results: Among 48 PCOS patients who were enrolled in the study, 14 patients responded to CC 50 mg, 26 patients responded to CC 100 mg and 8 patients were CC non-responders. We concluded that serum LH, fasting insulin, and BMI were significant predictors of response to ovulation with CC in PCOS patients.
Conclusions: In our study, we concluded that among the hormonal and biochemical parameters we studied serum LH, fasting insulin, and BMI are significant predictors of response of ovulation with CC in women with PCOS-related infertility. This may help physicians to counsel and select the proper infertility treatment for women with PCOS experiencing infertility so that it should be less time-consuming and cost-effective.
References
Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8(1):41.
Azziz R, Adashi EY. Stein and Leventhal: 80 years on. Am J Obstet Gynecol. 2016;214(2):247.e1-11.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.
Von Hofe J, Bates GW. Ovulation induction. Obstet Gynecol Clin North Am. 2015;42(1):27-37.
Azargoon A, Alavy Toussy J, Fakhr Darbanan F. Pregnancies following the use of sequential treatment of metformin and incremental doses of letrozole in clomiphene-resistant women with polycystic ovary syndrome. Iran J Reprod Med. 2012;10(1):33-40.
Homburg R. Clomiphene citrate-end of an era? A mini-review. Hum Reprod. 2005;20(8):2043-51.
Farquhar CM, Williamson K, Gudex G, Johnson NP, Garland J, Sadler L. A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome. Fertil Steril. 2002;78(2):404-11.
Badawy A, Abdel Aal I, Abulatta M. Clomiphene citrate or letrozole for ovulation induction in women with polycystic ovarian syndrome: a prospective randomized trial. Fertil Steril. 2009;92(3):849-52.
Amen AF, Salah M, Abozeid H, Elbaz M, Badran E. Evaluation of sonographic and biochemical markers of clomiphene citrate resistance in polycystic ovary syndrome. Fertility Sterility. 2014;102(3):e256-7.
Ellakwa HE, Sanad ZF, Hamza HA, Emara MA, Elsayed MA. Predictors of patient responses to ovulation induction with clomiphene citrate in patients with polycystic ovary syndrome experiencing infertility. Int J Gynaecol Obstet. 2016;133(1):59-63.
Imani B, Eijkemans MJ, te Velde ER, Habbema JD, Fauser BC. A nomogram to predict the probability of live birth after clomiphene citrate induction of ovulation in normogonadotropic oligomenorrheic infertility. Fertil Steril. 2002;77(1):91-7.
Kousta E, White DM, Franks S. Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update. 199;3(4):359-65.
Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S. Prediction of responsiveness to clomiphene citrate in infertile women with PCOS. J Reprod Infertil. 2019;20(3):143-50.
