Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Mostafa A. Sleem, Ibrahim I. Mohamed, Mahmoud S. Zakherah, Ahmed M. Abbas, Momen A. Kamel


Background: Polycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. This study aims to assess the rate of spontaneous ovulation and pregnancy in patients. The present study was a cross sectional study conducted at Woman's Health Hospital, Assiut University, Assiut, Egypt.

Methods: The current study was a cross sectional study carried out in Assiut Women's Health Hospital between the 1st October 2016 and 31st July 2017. The patients were selected as infertile patients with PCOD. The patient ages range between 20 and 35 years. The BMI is between 18 and 30 Kg/m2. The main outcome measure was the rate of spontaneous ovulation and spontaneous pregnancy in the 3 cycles.

Results: The mean age of the study participants was 26.64±4.59 years and the mean BMI was 24.46±2.62Kg/m2. The sonographic ovarian volume was 12.47±0.69 mm3 for the right ovary and 12.74±0.73 mm3 for the left ovary. No difference in the serum FSH, LH, FSH/LH ratio and prolactin over the 3 consecutive cycles. The rate of spontaneous ovulation in the 3 cycles was 6 women (8.6%) and 2 cases (2.8%) became pregnant spontaneously during the study period. There is no statistical significant difference between ovulating and non-ovulating women according to the BMI and ovarian volume.

Conclusions: The present study concluded that the rate of spontaneous ovulation was 8.6% in women with PCOD within 3 cycles with no adverse effects of drugs or surgical interference.


Infertility, Ovulation, Polycystic ovarian disease, Pregnancy

Full Text:



Ehrman DA. Polycystic ovary syndrome. New Eng J Med. 2005;352:1223-36.

Thomas S, Sudharshini S. Polycystic ovarian syndrome: Treatment options for infertility. Current Medical Issues. 2016;14(4):87-93.

Pandey S, Bhattacharya S. Impact of obesity on gynecology. Womens Health (Lond). 2010;6(1):107-17.

Jonard S, Dewailly D. The follicular excess in polycystic ovaries, due to intraovarianhyperandrogenism, may be the main culprit for the follicular arrest. Hum Reprod Update. 2004;10(2):107-17.

Burt Solorzano CM, McCartney CR, Blank SK, Knudsen KL, Marshall JC. Hyperandrogenaemia in adolescent girls: origins of abnormal gonadotropin- releasing hormone secretion. BJOG. 2002; 117(2):143-9.

Diamanti-Kandarakis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: Hormonal and metabolic profile. J ClinEndocrinolMetab. 1999;84:4006-11.

Al-Hussaini TK, Zakhera MS, Abdel-Aleem M, Abbas AM. Premature ovarian failure/dysfunction following surgical treatment of polycystic ovarian syndrome: A case series. Middle East Fertil Soc. 2017 [Article in press].

Salem MN, Ahmed SR, Abbas AM, Salem AN, Sabala AM. Short term effects of laparoscopic ovarian drilling in clomiphene citrate resistant patients with polycystic ovary syndrome. Middle East Fertil Soc. 2017 [Article in press].

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004 Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 81:19–25.

Hoeger KM. Obesity and lifestyle management in polycystic ovary syndrome. Clin Obstet Gynecol. 2007;50:277–94.

Pasquali R, Gambineri A, Pagotto U. The impact of obesity on reproduction in women with polycystic ovary syndrome. BJOG. 2006;113:1148–59.

Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod. 1998;13:1502–5.

Tolino A, Gambardella V, Caccavale C, D’Ettore A, Giannotti F, D’Anto V, et al. Evaluation of ovarian functionality after a dietary treatment in obese women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005;119:87–93.

Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility. 7th ed. Pennsylvania: Lippincott Williams & Wilkins;2005.

Kafy S, Tulandi T. New advances in ovulation induction. Curr Opin Obstet Gynecol 2007;19:248–52.

Neveu N, Granger L, St.-Michel P, Lavoie HB. Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction and achievement of pregnancy in 154 women with polycystic ovary syndrome. Fertil Steril 2007;87:113–20.

Randall JM, Templeton A. Transvaginal sonographic assessment of follicular and endometrial growth in spontaneous and clomiphene citrate cycles. Fertil Steril. 1991; 56:208–12

Creanga AA, Bradley HM, McCormick C, Takacs Witkop C. Use of metformin in polycystic ovary syndrome A metaanalysis. Obstet Gynecol. 2008;111:959–68.

Bayar U, Basaran M, Kiran S, Coskun A, Gezer S. Use of an aromatase inhibitor in patients with polycystic ovary syndrome: a prospective randomized trial. Fertil Steril 2006;86:1447–51.

Mercorio F, Mercorio A, Di Spiezio Sardo A, Barba GV, Pellicano M, Mappi C. Evaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy. Fertil Steril 2008;89:1229–33.