Novel clomiphene "stair-step" protocol reduces time to ovulation in women with polycystic ovarian syndrome

被引：21

作者：

Hurst, Bradley S. ^{[1
]}

Hickman, Jennifer M. ^{[1
]}

Matthews, Michelle L. ^{[1
]}

Usadi, Rebecca S. ^{[1
]}

Marshburn, Paul B. ^{[1
]}

机构：

[1] Carolinas Med Ctr, Div Reprod Endocrinol & Infertil, Dept Obstet & Gynecol, Charlotte, NC 28203 USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2009年 / 200卷 / 05期

关键词：

clomiphene; infertility; oligomenorrhea; polycystic ovarian syndrome; ultrasound; RESISTANT WOMEN; CITRATE; METFORMIN; INFERTILITY; INDUCTION;

D O I：

10.1016/j.ajog.2008.10.031

中图分类号：

R71 [妇产科学];

学科分类号：

100211 [妇产科学];

摘要：

OBJECTIVE: The objective of the study was to determine the efficacy of a novel "stair-step" clomiphene protocol in women with polycystic ovarian syndrome ( PCOS) who do not respond to 50 mg clomiphene. STUDY DESIGN: This was a retrospective analysis at an academic fertility center. The stair-step protocol is performed as follows: 50 mg clomiphene for 5 days, ultrasonography on days 11-14. If unresponsive, immediately begin 100 mg clomiphene for 5 days and repeat ultrasound in 1 week. If still unresponsive, begin 150 mg clomiphene for 5 days and repeat the ultrasound in 1 week. Stair-step cycles were compared with published historical clomiphene outcomes for women who were nonresponsive. RESULTS: The time to ovulation was 32-53 days less with the stair-step protocol compared with a traditional regimen. The dose-dependent ovulation rate was 64% at 100 mg with the stair-step protocol compared with 22% with a traditional regimen. CONCLUSION: It is not necessary to induce menses before increasing clomiphene doses in nonresponsive PCOS patients.

引用

页码：510.e1 / 510.e4

页数：4

共 20 条

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[2]

RETRACTED: Re: Extending clomiphene treatment in clomiphene-resistant women with PCOS: a randomized controlled trial (Expression of Concern of Vol 16, art no 825, 2008) (Retracted article. See vol. 47, 2023) [J].