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12- THE NUMBER OF FOLLICLES AND OVARIAN VOLUME IN THE ASSESSMENT OF RESPONSE TO CLOMIPHENE CITRATE TREATMENT IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Haifa Al-Shaheen

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2011 Volume: 17 Issue: 1 Pages: 78
Publisher: Basrah University جامعة البصرة

Abstract

Haifa Al-ShaheenCABOG, Consultant Obstetrician & Gynecologist, Basrah Maternity & Childhood HospitalE-mail: hayfa_alshaheen@yahoo.comAbstractThis prospected follow–up study was carried out over 12 months period (from 1stSeptember 2008 till 30th August 2009) in infertility clinic in Basrah maternity and childhospital to evaluate whether certain criteria assessed during initial screening (number offollicles and ovarian volume) could predict the response to ovulation induction withclomiphene citrate (CC) medication.Clinical, ultrasonographic and endocrine data were collected and analyzed on 58 womenwith oligomenorrhoea or secondary amenorrhoea with PCOS and infertility beforeinitiation of CC medication. The ovarian morphology were determined by transvaginalU/S which showed all women had altered ovarian morphology ( both ovaries had >10multiple small cyst of 2-9 mm, mean total follicular number (11.0±2.5) and enlargedovaries, mean ovarian volume (13.2±4.01). Thirty eight patients (65%) ovulate, theremaining 20 (35%) did not. Age, body mass index (BMI), ovarian volume, number ofsmall follicles, serum LH, testosterone and LH/FSH ratio in CC non responders were allsignificantly higher than in CC responders (P< 0.05).Data suggest that patients whose ovarian are less likely to respond to stimulation by CCtreatment, can be predicted on the basis of initial screening characteristics, such as:BMI, history (oligomenorrhoea, or secondary amenorrhoea) and number of follicles andmean ovarian volume.These ultrasonographic features & laboratory assays could be clinically useful fordistinguishing better the CC no responders from responders.These observations may add to ongoing discussion regarding etiological factorsinvolved in ovarian dysfunction in these patients and classification of anovulatoryinfertile women.

Keywords

FOLLICLES --- CLOMIPHENE --- POLYCYSTIC --- OVARIAN