Management of Women with Clomifene Citrate Resistant Polycystic Ovary Syndrome – An Evidence Based Approach

Is clomiphene citrate stair‐step protocol a good alternative to gonadotrophins in clomiphene‐resistant PCO patients? Prospective study

“…The OHSS that developed in three patients while on CC treatment was categorized as mild in all of them . Spontaneous resolution occurred within 2 weeks in two of them, while in the third it was prolonged due to pregnancy.…”

“…Clomiphene citrate resistance remains a challenge for the physician and, despite the various medications introduced for its management, the main two lines of treatment remain gonadotrophin therapy and laparoscopic ovarian drilling (LOD) …”

“…The CC group were treated with the stair‐step protocol as follows: (i) CC (sanofi‐aventis US, Bridgewater, NJ, USA) was started at a dose of 50 mg/day from the fifth day of a spontaneous or progestin‐induced cycle for 5 days (D5–D9 of the treatment cycle); (ii) ultrasonography was done on D12–D14, and if no dominant follicle was seen, the dose was increased to 100 mg/day starting on the same day of the ultrasound and given for 5 days; (iii) ultrasonography was repeated 1 week after the first scan (D19–D21), and if no dominant follicle was seen, the dose was increased to 150 mg/day starting on the same day of the ultrasound and given for 5 days; (iv) a third and final scan was done 1 week after the second (D28), and if still no dominant follicle was seen, the treatment was labeled a failure (Fig. ).…”