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Purpose  Clomiphene citrate ( CC ) has been used as a first‐line treatment for anovulatory polycystic ovary syndrome ( PCOS ). However, some patients with  PCOS  are resistant to standard  CC  treatment. In this study, a new  CC  treatment protocol was developed, named “intermittent  CC  treatment” ( ICT ) and its efficacy was investigated on the induction of follicular growth in patients with  PCOS  who were resistant to standard  CC  treatment.    Methods  Of the 42 patients with  PCOS  who were resistant to standard  CC  treatment (50 mg/day, 5 days), 26 underwent  ICT . They were given 100 mg/day of  CC  for 5 days from the next menstrual cycle day ( MCD ) 5 (first  CC ). If follicular growth was not observed on  MCD  14, they were given 100 mg/day of  CC  for 5 days ( MCD  14‐ MCD  18) (second  CC ). If follicular growth still was not observed on  MCD  23, they were treated with  CC  again in the same way (third  CC ).    Results  The first  CC , second  CC , and third  CC  were effective for 3/26 (11.5%) patients, 12/23 (52.2%) patients, and 6/11 (54.5%) patients, respectively. In total,  ICT  was effective for 21/26 (80.8%) patients with  CC ‐resistant  PCOS .    Conclusion  Thus,  ICT  is a useful treatment and could be an alternative to gonadotropin therapy for patients with  CC ‐resistant  PCOS .

reproductive medicine and biology

Usefulness of intermittent clomiphene citrate treatment for women with polycystic ovarian syndrome that is resistant to standard clomiphene citrate treatment