Document Detail


The choice of treatment for anovulation associated with polycystic ovary syndrome following failure to conceive with clomiphene.
MedLine Citation:
PMID:  8253919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The choice of treatment for clomiphene-resistant anovulation associated with polycystic ovary syndrome (PCOS) is presently arbitrary and selection criteria are not available. A total of 144 women with anovulatory infertility associated with PCOS who failed to conceive on clomiphene were treated with either pure follicle stimulating hormone (FSH) (n = 29), or human menopausal gonadotrophin (HMG) (n = 60), or gonadotrophin-releasing hormone analogue (GnRHa) and HMG (n = 55). Analysis of 306 treatment cycles and 53 pregnancies revealed a cumulative conception rate at 4 months of 23% with FSH, 47% with HMG and 69% with GnRHa + HMG. The miscarriage rate was highest in the HMG group (44%) and consequently the cumulative live birth rate was superior when GnRHa was used in combination with HMG. There were no significant differences in the basal clinical and endocrinological features of those who conceived compared with those who did not, either in the whole group, or in the individual treatment groups. Thus, the choice of treatment for clomiphene-resistant women with PCOS cannot be guided by the basal clinical or endocrinological features of this heterogeneous syndrome with the present state or knowledge.
Authors:
J Farhi; R Homburg; A Lerner; Z Ben-Rafael
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  8     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-01-11     Completed Date:  1994-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1367-71     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Golda Meir Medical Centre, Hasharon, Petah-Tikva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anovulation / drug therapy*,  etiology
Clomiphene / therapeutic use*
Drug Therapy, Combination
Female
Follicle Stimulating Hormone / therapeutic use
Gonadotropin-Releasing Hormone / administration & dosage,  analogs & derivatives
Humans
Menotropins / administration & dosage
Ovulation Induction / methods*
Polycystic Ovary Syndrome / complications*
Retrospective Studies
Treatment Failure
Triptorelin* / analogs & derivatives*
Chemical
Reg. No./Substance:
33515-09-2/Gonadotropin-Releasing Hormone; 57773-63-4/Triptorelin; 57773-65-6/Tryptal; 61489-71-2/Menotropins; 9002-68-0/Follicle Stimulating Hormone; 911-45-5/Clomiphene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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