Ovulation induction with low dose step-up protocol in PCOS patients with clomiphene citrate resistance Klomifen sitrata dirençli polikistik over sendromlu hastalarda kronik düşük doz "step-up" protokolü ile ovulasyon i̇ndüksiyonu
Jinekoloji ve Obstetrik Dergisi, cilt.17, sa.2, ss.107-111, 2003 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 17 Sayı: 2
- Basım Tarihi: 2003
- Dergi Adı: Jinekoloji ve Obstetrik Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.107-111
- Anahtar Kelimeler: Anovulation, Clomiphene Citrate Resistance, Ovulation Induction, PCOS
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: To evaluate the ovulation and pregnancy rates for chronic low dose step-up protocol in patients with infertility and a diagnosis of clomiphene citrate resistant anovulation due to PCOS between March 2000-April 2002. STUDY DESIGN: Clomiphene citrate resistant 28 patients were examined in a total of 32 cycles by applying low dose step-up protocol with recombinant FSH. Dose was incremented by half ampoule, based on the absence of a follicle 10 mm or larger after 14 days. Following that, the dose was increased by half ampoule every 7 days if an ovarian response was lacking. In the case of a sufficient ovarian response, the dose was kept constant until the administration of hCG. Results were evaluated in terms of ovulation rate, number of mature follides premature luteinization and pregnancy rates. RESULT(s): Unifollicular development in 15 cycles (47 %), 2 follicles in 11 cycles (34%), 3 follicles in 3 cycles (9%) were determined. Three cycles (9%) were cancelled due to multiple follicular development. Confirming by luteal phase progesterone measurement, ovulation was determined in 29 of 30 cycles (97%). Average time to ovulation was 13.3±5.4 days (7-29). Total gonadotropin dose was found to be 1184±777.5 IU (450-3412). Stimulation period was determined as 10 days or less in 25 cycles (66%). Average number of follicles was 1.66±0.66. Pregnancy occurred in 9 patients (9 cycles; 28 %), and continued in 6 of them, yielding an ongoing pregnancy rate of 19%. CONCLUSION(S): Ovulation induction could be efficiently achieved in PCOS patients who are resistant to clomiphene citrate, by applying low dose step-up protocol with recombinant FSH without frequent monitoring, with minor risk of OHSS and multiple pregnancies. Besides, this therapy regimen does not only increase chance of mono-follicular development and also decreases the OHSS frequency.