Treatment of infertility in women with Clomiphene -resistant polycystic ovary syndrome

Objective: To study the methods and effects of treatment in women with clomiphene(CC)-resistant polycystic ovary syndrome(PCOS). Methods: Forty six patients with CC-resistant PCOS were studied.They were divided into four groups with 69 treatment cycles, including Diane-35 plus CC(12 cases,18 cycles,group 1),Diane-35 plus FSH(11 cases,20 cycles,group 2),Metformin plus CC(12 cases,16 cycles,group 3)and Metformin plus FSH(11 cases,15 cycles,group 4).The rates of pregnancy and abortion, occurrence rates of ovarian hyperstimulation syndrome(OHSS) and multipregnancy were analysed. Results: The ovulation rates and pregnancy rates per cycle of the four groups were 77.8%,90%,81.3% and 93.3%, 16.7%,30%,18.8% and 33.3%, respectively.No correlation was found between ovulation rates and pregnancy rates in the four groups, although the group 2 and 4 had higher ovulation rate and pregnancy rate than the group 1 and 3.One cases aborted in group 1, and two cases had twins in group 2, another patient developed medium OHSS in group 4.There were no statistical significance among these groups. Conclusions: Before ovarian stimulation with low dosage CC or FSH in infertility women with CC-resistant cases,it is suitable to use pretreatment,which can reverse the endocrine abnormalities,and may improve the ovarian response.