Prednisolone With Clomiphene Citrate in Ovulation Induction in  Clomiphene Citrate-Resistant Polycystic Ovary Syndrome

Fadhil Al-Shaikh, Suhaila; Fadhil, Ibtisam

	Prednisolone With Clomiphene Citrate in Ovulation Induction in Clomiphene Citrate-Resistant Polycystic Ovary Syndrome
Medical Journal of Babylon
Article 1, Volume 7, Issue 3, 2010, Pages 571-578
Authors
Suhaila Fadhil Al-Shaikh; Ibtisam Fadhil
Abstract
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 1 st group than in the 2 nd 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.

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