CLINICAL ANALYSIS OF CLOMIPHENE CITRATE INDUCED OVULATION IN INFERTILITY PATIENTS WITH POLYCYSTIC OVARIAN DISEASE

2021 ◽  
Vol 4 (5) ◽  
Author(s):  
Preeti Suhas Deshpande
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Follicular Development ◽  
Pregnancy Rates ◽  
Initial Assessment ◽  
Infertile Women ◽  
The Mean

Background: Normo-gonadotrophic anovulation is the most prevalent anovulatory infertility type. Polycystic ovary disease (PCOS) is by far the most common cause in this category, accounting for 85 % of females who are anovulatory. Its prevalence is growing increasingly with increasing modernisation. Ovulation induction in PCOS females is a problem and the best drug for ovulation induction is still debatable. Aims & objectives: In the current research, we evaluated the efficacy of clomiphene citrate in infertile women with polycystic ovary disease for ovulation induction and pregnancy rates. Material and Methods: The present research was a prospective study conducted with PCOS, willing to participate and follow up in women with primary/secondary infertility. Rotterdam criteria were used to diagnose PCOS. Using descriptive statistics, statistical analysis was performed. Results: Initially, 140 patients in the current study were recruited. For the current research, 128 patients either born or cared for a full 6 months were considered. 21-25 years of age was the most common age group. The mean age of the patients examined was 26.34 ± 3.6 years. 55 % were having average BMI patients, while 34% were overweight. Primary infertility was present in 77 percent of patients. 73 per cent of patients had infertility duration of 1-5 years. 30 percent have a history of laparoscopic ovarian drilling in patients. In 58 percent, hirsutism was noted. Following serial USG monitoring, mono-follicular development (55 %) was more prevalent than multi-follicular development at the end of the study (45 percent). The mean thickness of the endometrium was 7.78 ± 2.58 mm. The mean days for clomiphene citrate ovulation are 14.84 ± 3.46. Average P4 values on day 21 were 11.48 ± 6.44 ng/ml. At the end of the study, 66 % ovulation rate, 28 % pregnancy rate, and 2 % multiple pregnancy incidence were noted. Conclusion: Ovulation induction with clomiphene citrate should be considered as the first line of treatment for infertile women with PCOS. Initial assessment and careful selection of patients increases pregnancy rates. Keywords: ovulation induction, polycystic ovary disease, clomiphene citrate, pregnancy rate.

scholarly journals Efficacy of letrozole versus clomiphene citrate for infertile women with polycystic ovary syndrome

2021 ◽  
Vol 10 (8) ◽  
pp. 2944
Author(s):  
Sinan S. Ay ◽  
Özer Birge ◽  
Mehmet S. Bakır ◽  
Ayşe E. Yumru
Keyword(s):  
Aromatase Inhibitor ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Appropriate Treatment ◽  
The Mean ◽  
Infertility Patients ◽  
Infertile Patients

Background: The aim was to compare ovulation induction protocols in anovulatory patients, who make up a significant percentage of infertility patients, and to determine the most appropriate treatment for patients in the clinic based on the findings.Methods: The effectiveness of clomiphene citrate (CC) and letrozole (aromatase inhibitor) in ovulation induction treatments were retrospectively compared in patients who applied for infertility in the last 5 years and were found to be anovulatory. 20 of these patients were being treated with clomiphene citrate, while the 18 were being treated with letrozole.Results: The study included a total of 38 anovulatory infertile patients. The mean age of the patients was found to be 29.3. When the endometrial thicknesses (ET) after the treatment were compared, the first group's mean EC was 6.1, while that of the second group was 9.05. The endometrial thicknesses measured after the treatments were found to be significantly different, which were consistent with other studies in the literature. Post-treatment ovulation responses were similar with 55% in both groups. In the evaluation of pregnancy outcomes, 20% of pregnancy was achieved in the first group and 33% in the second group.Conclusions: The use of letrozole, an aromatase inhibitor, may be suggested as an alternative to CC in the ovulation induction protocol in our clinical practice, particularly in obese patients.

scholarly journals Step-up protocol gonadotrophin versus laparoscopic ovarian drilling in clomiphene citrate resistant PCOS infertile women in two Iraqi hospitals

2019 ◽  
Vol 15 (1) ◽  
pp. 103-109
Author(s):  
Thikra N Abdull
Keyword(s):  
Pregnancy Rate ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Reproductive Age ◽  
Infertile Women ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome is a common endocrine disorder affecting 6-10% of women of reproductive age and the most common cause of anovulatory infertility. Objective: The aim of the study was to compare the effectiveness, side effects and outcomes of step-up gonadotrophin protocol versus laparoscopic ovarian diathermy (LOD) in infertile patients with clomiphene citrate resistant polycystic ovary syndrome. Methods:  The sample included women who attended our infertility clinic at Al-Elwiya Maternity Teaching Hospital and Kamal Al-Samarraee for Infertility and IVF Hospital in Baghdad/ Iraq from November 2013 to November 2014.    Eighty cases of infertile women with polycystic ovarian syndrome who failed to ovulate with clomiphene citrate for six months where collected, forty women treated with step-up protocol with low dose recombinant FSH gonadotrophin which increased gradually according to ovulation response, another forty women treated with LOD. Ovulation monitoring in each group was done with transvaginal ultrasound to exclude monofollicullar, bifollicular ovulation, ovarian hyperstimulation syndrome, multiple pregnancy and pregnancy rate in each cycle for 6 cycles. Results: Higher unifollicular ovulation and pregnancy rate in LOD than step-up protocol (91.4% & 25% versus 75% & 10%) respectively, while multifollicular and hyperstimulation rate were higher in gonadotrophin group (24.3% & 0.1% versus 8.50% & nil) respectively. Conclusion: Ovulation induction and pregnancy rate per cycle was higher with LOD group, not time consuming, also there was no risk of hyperstimulation of the ovary or twin pregnancy as compared to the step-up protocol with gonadotrophin

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

scholarly journals A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome

2019 ◽  
Vol 7 (9) ◽  
pp. 95 ◽  
Author(s):  
Michael Costello ◽  
Rhonda Garad ◽  
Roger Hart ◽  
Hayden Homer ◽  
Louise Johnson ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Reproductive Age ◽  
Supporting Evidence ◽  
First Line ◽  
Ovary Syndrome ◽  
Ultrasound Monitoring

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line medical ovulation induction therapy to improve fertility outcomes is letrozole, whilst other less efficacious ovulation induction agents, such as clomiphene citrate, metformin, and metformin combined with clomiphene citrate, may also be considered. Metformin combined with clomiphene citrate is more effective than clomiphene citrate alone. In obese women with PCOS, clomiphene citrate could be used in preference to metformin alone whilst clomiphene citrate could be added to metformin alone in order to improve reproductive outcome in all women with PCOS. Gonadotrophins, which are more effective than clomiphene citrate in therapy naïve women with PCOS, can be considered a first line therapy in the presence of ultrasound monitoring, following counselling on the cost and the potential risk of multiple pregnancy.

scholarly journals Comparing the Effect of Metformin and Acarbose Accompanying Clomiphene on the Successful Ovulation Induction in Infertile Women with Polycystic Ovary Syndrome

2016 ◽  
Vol 8 (9) ◽  
pp. 281
Author(s):  
Masomeh Rezai ◽  
Mohmmad Jamshidi ◽  
Robabeh Mohammadbeigi ◽  
Fariba Seyedoshohadaei ◽  
Somaye Mohammadipour ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Glucose Tolerance ◽  
Treatment Period ◽  
Ovulation Induction ◽  
Glucose Tolerance Test ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
The Mean

The aim of this study was to compare the effects of Metformin and Acarbose accompanying Clomiphene on the successful ovulation induction in infertile women with polycystic ovary syndrome.This randomized double blind clinical trial study was performed on 60 women with polycystic ovary syndrome. Women were selected and randomly divided in two control and intervention groups. Intervention group received Acarbose 100 mg/day for 3 months. In the first, second, and third weeks, they received 1 tablet, 2 tablets, and 3 tablets per day respectively. In addition, they received 100 mg Clomiphene from third to seventh day of menstruation, during the 3 month treatment period. The control group received Metformin 500 mg/day for 3 months. In the first, second, and third weeks, they received 1 tablet, 2 tablets, and 3 tablets per day respectively. In addition, they received 100 mg Clomiphene from third to seventh day of menstruation, during the 3 month treatment period. All the subjects in both groups before and after the treatment were examined for hirsutism, acne, oral glucose tolerance test, serum triglycerides, cholesterol, LDL, HDL. Also, induction of ovulation was assessed by vaginal ultrasound. The Mean of BMI and fasting glucose tolerance test in Acarbose group was less than Metformin group (P = 0.05). The mean of triglycerides, LDL and HDL levels did not differ between the two groups after the intervention (P &gt; 0.05). The mean of cholesterol levels were different in the two groups after the intervention (P = 0.04). Frequency of ovulation induction in those who received Acarbose (78.5%) was more than those who received Metformin (46.6) (P = 0.012). Comparing with Metformin, Acarbose accompanying Clomiphene was more effective in ovulation induction and decreasing body mass index in infertile women with polycystic ovary syndrome.

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

scholarly journals Comparative study of clomiphene citrate versus letrozole as first-line ovulation induction drug in infertile polycystic ovary syndrome women

2020 ◽  
Vol 9 (7) ◽  
pp. 2948
Author(s):  
Mahija Sahu ◽  
Nihar Ranjan Rout
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Ovulation Rate ◽  
First Line ◽  
Ovary Syndrome ◽  
Standard Drug

Background: Polycystic ovary syndrome is the commonest endocrinopathy resulting in anovulatory infertile young women. Clomifene citrate (clomiphene) is a long-standing standard drug for ovulation induction, and is still considered as first line option in PCOS women. However, clomiphene has certain disadvantage letrozole an aromatase inhibitor acts by reducing estrogen production and has no adverse effects on endometrium and cervical mucous. Indian PCOS women have high prevalence of insulin resistance and thus are likely to have high clomiphene resistance. So letrozole could prove to be a good alternative for ovulation induction in such women.Methods: This was a prospective randomized, parallel, comparative clinical trial of two ovulation induction drugs letrozole 5 mg versus clomiphene citrate 100 mg as first-line ovulation induction drug in infertile polycystic ovarian syndrome women. The target population of the study was one hundred infertile women with PCO (taking at least 2 Rotterdam’s parameters). 50 women were allocated to clomifene citrate and 50 were allocated to Letrozole for ovulation induction. Parameters like age, duration of infertility, B MI, ovulation rate, number of follicles, pregnancy rate, endometrial thickness were noted and analyzed.Results: In letrozole group, the ovulation rate, mono-follicular development, mean endometrial thickness and pregnancy rate was better in comparison to clomifene citrate group.Conclusions: The result of this study suggests that letrozole may replace clomiphene as the first line drug for ovulation induction in infertile PCOS women.

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