Prednisolone with clomiphene citrate in ovulation induction in clomiphene citrate-resistant polycystic ovary syndrome

Abstract EN

The aim of this work was to evaluate the efficacy of adding prednisolone to clomiphene citrate (CC) in CC-resistant polycystic ovary syndrome (PCOS) in induction of ovulation.

Methods : forty three infertile women with CC resistant PCOS were randomly assigned into two groups.

Group I (31 patients 72.09 %) : Clomiphene citrate 100 mg / day was given from day 2 to day 6 of the cycle and prednisolone 10 mg / day from day 2 to day 12 of the cycle.

Group II (12 patients 27.9 %) : CC 150 mg / day was given from day 2 to day 6 of the cycle.

The main outcome was ovulation.

Secondary measures included endometrial thickness and pregnancy rate.

Ovarian follicular response was monitored by transvaginal ultrasound.

HCG 10 000 U was given when at least one follicle measured 18 mm, and timed intercourse was advised.

Results : There were no statistically significant differences between groups regarding the age, duration of infertility, menstrual pattern, hirsutism, and PCO features by U / S.

the mean endometrial thickness were significantly higher in the 1st group than in the 2nd group (P < 0.05).

Similarly, there were significantly higher rates of ovulation (74.19 versus 16.66 %) (P < 0.001) and pregnancy rate (54.84 % versus 8.33 %) (P < 0.05).

Prednisolone was very well tolerated as no patients complained of any side effect.

Conclusion: Induction of ovulation by adding prednisolone to CC in CC-resistant PCOS is associated with no adverse anti-estrogenic effect on the endometrium and higher ovulation and pregnancy rates in a significant number of patients.