Published: 2017-07-26

A comparative study of ovulation induction with clomiphene versus clomiphene and bromocriptine in follicular phase of normoprolactinemic PCOS women

S. R. Gayathri, Saswati Tripathy, M. Muthulakshmi


Background: Hypothalamic pituitary axis dysfunction accounts for majority of ovulatory disorders and a predominant cause of women with PCOS. There is a dopaminergic control on gonadotropin secretion. In normoprolactinemic PCOS patients transient rise in serum prolactin can be observed during the late follicular phase and luteal phase. So, the aim of the study is to know the effect of bromocriptine and clomiphene in ovulation induction as compared to clomiphene alone.

Methods: Based on the various inclusion and exclusion criteria, seventy patients were randomly assigned into two groups. The patients in the first group were treated with tablet of clomiphene citrate (100 mg) from day 3 to day 7 of each cycle. The patients in the other group received 100mg of clomiphene citrate from day 3 to day 7 of each cycle and tablet bromocriptine (2.5 mg) from day5 to day14. Both groups were followed up with follicular study for three months. At the end of the three cycles the hormonal statuses of the patients were determined.

Results: There was no significant difference found in other hormones like serum FSH, LH and estradiol in both groups. The follicular diameter and the average endometrial thickness was increased to a significant level in the CC+Bcrt group as compared to the CC group. The rate of ovulation and pregnancy rate was higher in combination group.

Conclusions: Bromocriptine with clomiphene in follicular phase has an advantage of improving follicular diameter, endometrial thickness and hence ovulation and pregnancy rates.



Bromocriptine, Clomiphene citrate, PCOS

Full Text:



Hamberger L, Janson P.O. Global importance of infertility and its treatment: role of fertility technologies. Int J Gynaecol Obstet. 1997;58:149-58.

Marc AF, Speroff L. Induction of ovulation. Clinical gynecologic endocrinology and infertilfity. 8th Ed. India: Wolters Kluwer;2011:1294.

Vekemans M, Delvoye P, L'Hermite M, Robyn C. Serum prolactin levels during the menstrual cycle. J Clin Endocrinol Metab. 1977;44(5):989-93.

Doldin, Papaleo E, Desantis L. Hyperprolactinemia in IVF cycles: treatment versus no treatment and outcome of ovarian stimulation, oocyte retreival and oocyt quality. Gynecol Endocrinol. 2000;14:437-441

Ergur A. Clomiphene citrate resistant polycystic ovary syndrome. J Reprod Med. 1998;43:185-90.

Marco C. Effects of clomiphene citrate on androgens in polycystic ovary syndrome. Archiv Gynecol Obestet. 1998;261:117-20.

Mitwally FM, Casper RF. Use of aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril. 2001;75:350-9.

Kousra E, White DM, Franks S. Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update. 1997;3:359-65.

Porcile A, Gallardo E, Venegas E. Normoprolactinemic anovulation nonresponsive to clomiphene citrate: ovulation induction with bromocriptine. Fertil Steril. 1990;53(1):50-5.

Akhlaghi F, Hamedi A. Investigation on the effects of bromocriptine and dexamethasone in polycystic ovarian disease wirh clomiphene citrate resistance. Int Gynecol Obstet. 2004;3:1-5.

Anzhen Y, Liang Y Treatment of bromocriptine in the patients with normal prolact in levels for ovulation induction. Chin Comp Clin. 2006;22:275- 6.

Haixia W. Clinical observation of treatm ent in unexplained infertility with bromocriptine. Shandong Chin Med. 2002;42:19.