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Is clomiphene citrate stair‐step protocol a good alternative to gonadotrophins in clomiphene‐resistant PCO patients? Prospective study
Author(s) -
Salaheldin AbdelHamid Amr M.,
Rateb Ahmed M.,
Ismail Madkour Wael A.
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12940
Subject(s) - medicine , ovulation , polycystic ovary , infertility , pregnancy rate , follicle stimulating hormone , gynecology , prospective cohort study , pregnancy , luteinizing hormone , hormone , insulin resistance , insulin , biology , genetics
Aim To compare the efficacy and safety of the clomiphene citrate (CC) stair‐step protocol with standard gonadotrophin (follicle‐stimulating hormone) treatment in clomiphene‐resistant polycystic ovary syndrome (PCOS) patients. The study was a prospective cohort study in a tertiary infertility center in Abu Dhabi , United Arab Emirates ( UAE ). Methods The subjects consisted of 100 PCOS CC‐resistant patients who attended between January 2014 and January 2015. Fifty received CC again but in accordance with the stair‐step protocol, and the other 50 received the standard gonadotrophin treatment used in the center in which the study was conducted. The primary outcome measure was dominant follicle achievement; the secondary outcome measures were (i) clinical pregnancy rate; (ii) time to ovulation measured from treatment initiation to sonographic confirmation of a dominant follicle in days; and (iii) adverse effect occurrence. Results There was no difference between the two treatment modalities concerning the ability to achieve a dominant follicle or the clinical pregnancy rate. The time to ovulation was significantly shorter with the CC stair‐step protocol than with gonadotrophin treatment. Ovarian hyperstimulation syndrome and ovarian cyst formation were more likely to occur with gonadotrophin treatment. Conclusion Clomiphene citrate stair‐step protocol can be offered to PCOS CC‐resistant patients as an alternative to gonadotrophin therapy with similar efficacy.