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Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndrome: Randomized cross-over trial.
J Obstet Gynaecol Res. 2016 Aug; 42(8):966-71.JO

Abstract

AIM

To compare the ovarian response to early versus late clomiphene citrate (CC) in women with polycystic ovary syndrome (PCOS).

METHODS

This cross-over randomized controlled clinical trial included 90 infertile amenorrheic women with PCOS. After inducing withdrawal bleeding, patients were randomly divided into two equal groups to receive ovulation induction with CC 100 mg/day for 5 days. Group I started treatment the next day after finishing medroxyprogesterone acetate course for a menstrual cycle, and after a washout period of another menstrual cycle, the treatment was shifted to start on day 2 of withdrawal bleeding. Group II received a reversed protocol: late then early treatment. Women were followed up on transvaginal ultrasonography to monitor follicular growth, endometrial thickness and evidence of ovulation. Human chorionic gonadotropin 10 000 IU was given i.m. to trigger ovulation when at least one mature follicle measured ≥18 mm at day 14.

RESULTS

In all cases, early induction protocol resulted in significantly higher proportion of ovulating patients, thicker endometrium and higher number of follicles 14-17 mm in diameter, ≥ 18 mm in diameter and total number of follicles (P < 0.001 for all comparisons).

CONCLUSION

In women with PCOS, early initiation of CC before withdrawal bleeding or during the last days of the luteal phase can achieve a better ovulatory response.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Elbohoty AE
Department of Obstetrics and Gynecology, Faculty of Medicine, AinShams University, Abbasia, Cairo, Egypt.
Amer M
Department of Obstetrics and Gynecology, Faculty of Medicine, AinShams University, Abbasia, Cairo, Egypt.
Abdelmoaz M
Department of Obstetrics and Gynecology, Faculty of Medicine, AinShams University, Abbasia, Cairo, Egypt.

MeSH

AdultAmenorrheaAnovulationClomipheneEstrogen AntagonistsFemaleFertility Agents, FemaleHumansInfertility, FemaleOvulation InductionPolycystic Ovary Syndrome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27126971

Citation

Elbohoty, Ahmed E H., et al. "Clomiphene Citrate Before and After Withdrawal Bleeding for Induction of Ovulation in Women With Polycystic Ovary Syndrome: Randomized Cross-over Trial." The Journal of Obstetrics and Gynaecology Research, vol. 42, no. 8, 2016, pp. 966-71.
Elbohoty AE, Amer M, Abdelmoaz M. Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndrome: Randomized cross-over trial. J Obstet Gynaecol Res. 2016;42(8):966-71.
Elbohoty, A. E., Amer, M., & Abdelmoaz, M. (2016). Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndrome: Randomized cross-over trial. The Journal of Obstetrics and Gynaecology Research, 42(8), 966-71. https://doi.org/10.1111/jog.12996
Elbohoty AE, Amer M, Abdelmoaz M. Clomiphene Citrate Before and After Withdrawal Bleeding for Induction of Ovulation in Women With Polycystic Ovary Syndrome: Randomized Cross-over Trial. J Obstet Gynaecol Res. 2016;42(8):966-71. PubMed PMID: 27126971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndrome: Randomized cross-over trial. AU - Elbohoty,Ahmed E H, AU - Amer,Mohamed, AU - Abdelmoaz,Mohamed, Y1 - 2016/04/28/ PY - 2015/10/15/received PY - 2016/02/18/accepted PY - 2016/4/30/entrez PY - 2016/4/30/pubmed PY - 2017/4/22/medline KW - ClinicalTrials.gov Identifier: NCT02024984 KW - amenorrhea KW - anovulation KW - clomiphene citrate KW - induction of ovulation KW - polycystic ovary syndrome SP - 966 EP - 71 JF - The journal of obstetrics and gynaecology research JO - J Obstet Gynaecol Res VL - 42 IS - 8 N2 - AIM: To compare the ovarian response to early versus late clomiphene citrate (CC) in women with polycystic ovary syndrome (PCOS). METHODS: This cross-over randomized controlled clinical trial included 90 infertile amenorrheic women with PCOS. After inducing withdrawal bleeding, patients were randomly divided into two equal groups to receive ovulation induction with CC 100 mg/day for 5 days. Group I started treatment the next day after finishing medroxyprogesterone acetate course for a menstrual cycle, and after a washout period of another menstrual cycle, the treatment was shifted to start on day 2 of withdrawal bleeding. Group II received a reversed protocol: late then early treatment. Women were followed up on transvaginal ultrasonography to monitor follicular growth, endometrial thickness and evidence of ovulation. Human chorionic gonadotropin 10 000 IU was given i.m. to trigger ovulation when at least one mature follicle measured ≥18 mm at day 14. RESULTS: In all cases, early induction protocol resulted in significantly higher proportion of ovulating patients, thicker endometrium and higher number of follicles 14-17 mm in diameter, ≥ 18 mm in diameter and total number of follicles (P < 0.001 for all comparisons). CONCLUSION: In women with PCOS, early initiation of CC before withdrawal bleeding or during the last days of the luteal phase can achieve a better ovulatory response. SN - 1447-0756 UR - https://www.unboundmedicine.com/medline/citation/27126971/Clomiphene_citrate_before_and_after_withdrawal_bleeding_for_induction_of_ovulation_in_women_with_polycystic_ovary_syndrome:_Randomized_cross_over_trial_ DB - PRIME DP - Unbound Medicine ER -
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