Extended Clomiphene Citrate (CC) and Prednisone for the Treatment of Clomiphene-Resistant Anovulatory Women with the Polycystic Ovary Syndrome (PCOS)


AbstractObjective: To evaluate the effectiveness of a regimen of extended clomiphene Citrate (CC) and prednisone for the treatment of clomiphene-resistant polycystic ovary syndrome (PCOS) patients who had failed to ovulate on CC alone.Design: Prospective interventional study.Setting: Department of Obstetrics and Gynaecology/ Al-Yarmouk Teaching Hospital during the period September 2001 through February 2002.Patients & Methods: Twenty-one anovulatory (PCOS) patients who failed to ovulate after clomiphene citrate (CC) treatment administered for 5 days. Treatment consisted of CC, 100 mg, given on cycle days 3 through 9 (extended). Additionally, patients were given prednisone 5 mg orally each night throughout the cycle. Ovulation was confirmed by midluteal serum progesterone levels. Pregnancy was confirmed by serum hCG Levels and 7-week gestation ultrasound.Results: A total of 21 patients completed 53 cycles of treatment with extended CC and prednisone (mean, 2.5 cycles; range 1-6 cycles). Sixteen (76%) of 21 patients became ovulatory and 40 (75%) of treatment cycles resulted in ovulation. Eleven of 21 patients, (52%) conceived with this therapy. In the conception group, one ended in spontaneous abortion.Conclusion: The treatment with extended CC and prednisone is an economic, safe and effective alternative treatment for PCOS patients in whom the classical treatment with CC has failed.Keywords: Clomiphene Citrate, Prednisone, Polycystic Ovary Syndrome (PCOS)