The number of follicles and ovarian volume in the assessment of response to clomiphene citrate treatment in women with polycystic ovarian syndrome

Abstract EN

his prospected follow–up study was carried out over 12 months period (from 1st September 2008 till 30th August 2009) in infertility clinic in Basrah maternity and child hospital to evaluate whether certain criteria assessed during initial screening (number of follicles and ovarian volume) could predict the response to ovulation induction with clomiphene citrate (CC) medication.

Clinical, ultrasonographic and endocrine data were collected and analyzed on 58 women with oligomenorrhoea or secondary amenorrhoea with PCOS and infertility before initiation of CC medication.

The ovarian morphology were determined by transvaginal U/S which showed all women had altered ovarian morphology ( both ovaries had >10 multiple small cyst of 2-9 mm, mean total follicular number (11.0±2.5) and enlarged ovaries, mean ovarian volume (13.2±4.01).

Thirty eight patients (65%) ovulate, the remaining 20 (35%) did not.

Age, body mass index (BMI), ovarian volume, number of small follicles, serum LH, testosterone and LH/FSH ratio in CC non responders were all significantly higher than in CC responders (P< 0.05).

Data suggest that patients whose ovarian are less likely to respond to stimulation by CC treatment, can be predicted on the basis of initial screening characteristics, such as: BMI, history (oligomenorrhoea, or secondary amenorrhoea) and number of follicles and mean ovarian volume.

These ultrasonographic features & laboratory assays could be clinically useful for distinguishing better the CC no responders from responders.

These observations may add to ongoing discussion regarding etiological factors involved in ovarian dysfunction in these patients and classification of anovulatory infertile women.