Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome |
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Authors: | Ozlem Kosar Gulnur Ozaksit Mine Islimye Taskin |
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Affiliation: | 1. Eskisehir Sakarya Hospital, Eskisehir, Turkey 2. Department of Obstetrics and Gynecology, Ankara Dr Zekai Tahir Burak Women Health Teaching and Research Hospital, Ankara, Turkey 3. Department of Obstetrics and Gynecology, Balikesir University School of Medicine, Balikesir, Turkey 4. Bahcelievler Mah. Yay Sit. 35/2, 10050, Balikesir, Turkey
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Abstract: | Purpose The aim was to test a new protocol of luteal phase administration of clomiphene citrate (CC) for ovulation induction in women with polycystic ovary syndrome (PCOS). Methods This was a prospective, randomized, controlled trial. Two hundred and fifty-two women (cycles) with PCOS were utilized to create two groups. Patients in Group 1 (126 patients) received 100 mg of CC daily for 5 days starting on day 5 of menses, and patients in Group 2 (126 patients) received 100 mg of CC daily for 5 days starting the next day after finishing medroxyprogesterone acetate (MPA) (before withdrawal bleeding). The main outcome measures were the number of growing and mature follicles, serum E2 (in pg/mL), serum progesterone (in ng/mL) levels, endometrial thickness (in mm), pregnancy, and miscarriage rates. Results The total number of follicles and the number of follicles ≥14 mm during stimulation were significantly greater in Group 2. The endometrial thickness at the time of human chorionic gonadotrophin (hCG) administration was significantly greater in Group 2 as compared to Group 1 (7.84 ± 1.22 and 8.81 ± 0.9, respectively). Serum E2 levels were also significantly higher (p < 0.05) in Group 2 as compared to Group 1 (449.61 ± 243.45 vs. 666.09 ± 153.41 pg/mL). Pregnancy occurred in 13 patients (10.3 %) in Group 2 and in 11 patients (8.7 %) in Group 1. The difference was not statistically significant. Conclusion Luteal phase administration of CC in patients with PCOS leads to increased follicular growth and endometrial thickness, which might result in a higher pregnancy rate. |
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