Beneficial Effects of Addition of Glucocorticoid during Induction of Ovulation by Letrozole in Polycystic Ovarian Syndrome

Abstract

Objective: The aim of the study was to explore the efficacy of glucocorticoid in folliculogenesis and ovulation during induction of ovulation by letrozole in polycystic ovarian syndrome (PCOS). Materials and methods:This experimental study was conducted in Dhaka Medical College and Hospital and Infertility Care and Research Centre (ICRC) Dhaka, Bangladesh. Two hundred and eighty infertile patients with PCOS, who failed to ovulate by letrozole 10 mg/day for 5 days were the target population of this study. The patients received glucocorticoid (Dexamethasone) 0.5 mg every alternate day from D2 of the cycle till D10 along with same dose of letrozole in subsequent cycles. Only letrozole-treated cycles were taken as control and letrozole plus glucocorticoid-treated cycles were taken as experimental. Monitoring was done by transvaginal ultrasonography. Six ovulatory cycles were observed for pregnancy. Main outcome measures were ovulation and pregnancy.Results: Baseline characteristics were similar as same patients were taken as control and experimental. One hundred and eighty-two (65%) patients were ovulated and 93 (33.21%) patients got pregnant after addition of glucocorticoid. Conclusion:In PCOS addition of glucocorticoid during induction of ovulation appears to cause significant improvement in folliculogenesis, ovulation and pregnancy.