Prednisolone With Clomiphene Citrate in Ovulation Induction in Clomiphene Citrate-Resistant Polycystic Ovary Syndrome
 
  Dr Suhaila Fadhil Al-Shaikh FABMS. OG ,FIBMS.OG    Lecturer/ college of medicine/ Babylon university       
                
 

                                                                                           
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 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.
 
 
key words: pcos, ovulation induction, prednisolone, infertility