Management of women with polycystic ovary syndrome who experienced premature luteinization during clomiphene citrate treatment

Arie L. Lidor, Mordechai Goldenberg, Shlomo B. Cohen, Daniel S. Seidman, Shlomo Mashiach, Jaron Rabinovici

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the preferred treatment modality in patients with PCOS who experienced premature luteinization during CC treatment. Design: Prospective randomized study. Setting: Tertiary medical center. Patients: Twenty-two infertile women with PCOS demonstrating premature luteinization during at least two consecutive CC cycles. Interventions: Randomized induction of ovulation either with FSH alone or with GnRH agonist combined with FSH for a single treatment cycle. Main Outcome Measures: Premature luteinization was defined as serum progesterone >1.5 ng/mL before hCG administration. Results: Premature luteinization occurred in eight of the 10 patients (80%) in group A and in two of the 12 patients in group B (16.6%). This result corresponds to the higher mean (±SD) progesterone level present in group A patients as compared to those in group B (2.0 ± 1.2 ng/mL vs. 1.2 ± 0.6 ng/mL, P = 0.03). No pregnancies were achieved in group A, whereas the pregnancy rate per cycle observed in group B was 33.3% (4/12). On the day of hCG administration, the maximum mean (±SD) estradiol level was significantly lower (P < 0.0001) in group A (210.6 ± 37.9 pg/mL) than in group B (600.3 ± 253.8 pg/mL). The treatment duration and the number of FSH ampules used did not differ between the groups. Conclusions: Pituitary desensitization with GnRH analog in combination with FSH is superior to FSH- only treatment in PCOS patients who demonstrate premature luteinization during CC treatment. (C) 2000 by American Society for Reproductive Medicine.

Original languageEnglish
Pages (from-to)749-752
Number of pages4
JournalFertility and Sterility
Volume74
Issue number4
DOIs
StatePublished - Oct 2000

Keywords

  • Gonadotropin-releasing hormone agonist
  • Polycystic ovary syndrome
  • Premature luteinization

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