General Gynecology and Pelvic Floor
Mahnaz Ashrafi; Behnood Farazmand; Souzan Soufizadeh Balaneji; Maryam Dadkhah
Articles in Press, Accepted Manuscript, Available Online from 01 October 2023
Abstract
Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ...
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Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ovulation induction with clomiphene and letrozole versus clomiphene and human gonadotropin. This study aimed to compare an aromatase inhibitor with human gonadotropin for patients with clomiphene-resistant polycystic ovary syndrome. Methods: This randomized clinical trial was conducted on PCOS women resistant to clomiphene at Akbarabadi hospital, Tehran, Iran. Patients were randomly divided into two groups. The first group received letrozole and clomiphene citrate and the second received clomiphene citrate and human gonadotropin.Results: Total number of 120 patients enrolled in our study. No significant difference was seen between the two groups in terms of demographic and basic clinical characteristics (P>0.05). We also found no significant difference between the two groups in terms of hirsutism, galactorrhea, pregnancy rate, human chorionic gonadotropin (HCG) intake, primary and secondary infertility, and number of follicles (P>0.05). Conclusion: The combination of letrozole and clomiphene citrate was as effective as human gonadotropin and clomiphene citrate and it could be a treatment option for patients with infertility due to PCOS.Keywords: Clomiphene, Human menopausal gonadotropin, Letrozole, Polycystic ovary syndrome, Ovulation
Obstetrics and Gynecology
Mahnaz Ashrafi; Sahar Golmohammadi
Volume 8, Issue 1 , January and February 2023, , Pages 23-28
Abstract
Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and ...
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Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and their effects on clomiphene resistance in infertile women.Materials & Methods: In this descriptive-comparative cross-sectional study, 200 consecutive PCOD women with infertility taking clomiphene who were reffered to Akbarabadi hospital in 2017 and 2018 were enrolled. Different PCOD phenotypes and their effects on clomiphene resistance among these women were assessed.Results: The results showed that A, B, C, and D phenotypes were observed in 79 (39.5%), 13 (6.5%), 51 (25.5%), and 57 (28.5%) patients, respectively. Sixty-one patients (30.5%) had resistance. Despite no significant difference between phenotypes (P=0.064), the most common PCOD phenotype was A (HA+OA+PCO) found in 39.2% and D (OA+PCO) was seen in 29.8% of the patients.Conclusion: According to the results, there was no significant association between PCOD phenotypes and clomiphene resistance. Finally, A and D phenotypes were frequent types with clomiphene resistance.
