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textabstractThe diagnostic criteria used to identify patients suffering from\udpolycystic ovary syndrome remain controversial. The present prospective\udlongitudinal follow-up study was designed to identify whether certain\udcriteria assessed during standardized initial screening could predict the\udresponse to ovulation induction with clomiphene citrate (CC) in 201\udpatients presenting with oligomenorrhea or amenorrhea and infertility.\udSerum FSH levels were within the normal range (1-10 IU/L), and all\udpatients underwent spontaneous or progestin-induced withdrawal bleeding.\udInitial CC doses were 50 mg daily for 5 days starting on cycle day 3. In\udthe case of an absent response, doses were increased to 100 and 150 mg\uddaily in subsequent cycles. First ovulation with CC was used as the end\udpoint. After a complete follow-up (in the case of a nonresponse, at least\ud3 treatment cycles with daily CC doses up to 150 mg), 156 patients (78%)\udovulated. The free androgen index (FAI = testosterone/sex hormone-binding\udglobulin ratio), body mass index (BMI), cycle history (oligomenorrhea vs.\udamenorrhea), serum androgen (testosterone and/or androstenedione) levels,\udand mean ovarian volume assessed by transvaginal sonography were all\udsignificantly different (P < 0.01) in responders from those in\udnonresponders. FAI was chosen to be the best predictor in univariate\udanalysis. The area under the receiver operating characteristics curve in a\udmultivariate prediction model including FAI, BMI, cycle history, and mean\udovarian volume was 0.82. Patients whose ovaries are less likely to respond\udto stimulation by FSH due to CC treatment can be predicted on the basis of\udinitial screening characteristics, such as FAI, BMI, cycle history\ud(oligomenorrhea or amenorrhea), and mean ovarian volume. These\udobservations may add to ongoing discussion regarding etiological factors\udinvolved in ovarian dysfunction in these patients and classification of\udnormogonadotropic anovulatory infertile women

Predictors of Patients Remaining Anovulatory during Clomiphene Citrate Induction of Ovulation in Normogonadotropic Oligoamenorrheic Infertility