Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome: a systematic review and meta-analysis

Abstract

It appeared that late luteal phase CC for ovulation induction might be an effective method for ovulation induction in women with PCOS compared to conventional CC administration. Further intensive randomized-controlled studies should be warranted to define the efficacy of CC used in late luteal phase.

Effect of clomiphene citrate on endometrial thickness, ovulation, pregnancy and live birth in anovulatory women: systematic review and meta‐analysis

“…Most of the systematic reviews comparing ovulation induction drugs in women with WHO group II ovulatory disorders have not reported on EMT. Ding et al . compared CC used in the luteal phase vs CC used in the follicular phase and found significantly thicker EMT in the latter group after pooled analysis of four studies.…”

“…Most of the systematic reviews comparing ovulation induction drugs in women with WHO group II ovulatory disorders have not reported on EMT 4,7,56-62 . Ding et al 63 compared CC used in the luteal phase vs CC used in the follicular phase and found significantly thicker EMT in the latter group after pooled analysis of four studies. Another meta-analysis reported mid-cycle EMT in five studies but pooled analysis was not performed due to the significant heterogeneity 64 .…”

The curious case of premature luteinization

“…Luteal ovulation induction is a concept which was first introduced in ART for fertility preservation purposes in oncological cases [86]. It has recently been introduced as a way to increase success rates in women with PCOS or in women with poor ovarian reserve either alone or in combination with follicular phase stimulation within a single menstrual cycle (dual stimulation) [87,88]. Clomiphene citrate (CC) administration during the luteal phase has the advantage that it allows sufficient time up to implantation in order to overcome the adverse CC effect on the implantation potential of the endometrium and on the early pregnancy.…”

“…Clomiphene citrate (CC) administration during the luteal phase has the advantage that it allows sufficient time up to implantation in order to overcome the adverse CC effect on the implantation potential of the endometrium and on the early pregnancy. A 2015 meta-analysis comparing CC use during the late luteal phase versus the early follicular phase concluded that luteal induction yielded more oocytes and improved endometrial thickness without this translating into higher pregnancy rates or reduced miscarriage rates [88]. Although the protocols vary between the studies on luteal ovulation induction (in terms of type and timing of stimulation-early/mid/late luteal phase), it would be interesting to see if this approach affects PL rates.…”

Comparative effectiveness of 9 ovulation-induction therapies in patients with clomiphene citrate-resistant polycystic ovary syndrome: a network meta-analysis

“…Numerous pairwise meta-analyses have tried to identify the efficacies of the above-mentioned therapies in CCR-PCOS patients 5–9 . However, traditional meta-analyses are not based on the full range of all widely used therapies and give limited suggestions to choose the most efficacious therapy for mono-ovulation in CCR-PCOS patients.…”