Ovulation induction in clomiphene-resistant anovulatory women with normal dehydroepiandrosterone sulfate levels: beneficial effects of the addition of dexamethasone during the follicular phase

Trott, Edward A.; Plouffe, Leo; Hansen, Keith A.; Hines, Randall S.; Brann, Darrell W.; Mahesh, Virendra B.

doi:10.1016/s0015-0282(16)58525-2

Cited by 37 publications

(10 citation statements)

References 4 publications

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“…It is not only effective in hyperandrogenic women 6,7,24,26 but also has been shown to be effective in CC resistant women with normal levels of DHEAS. 6,25 In our series we also found effective result by using lowdose glucocorticoid therapy even with normal androgen levels. Eighty percent patients ovulated after administration of lowdose glucocorticoid along with letrozole therapy.…”

Section: Discussionsupporting

confidence: 65%

“…Glucocorticoids reduce total circulating androgen levels as much as 40% 5-7 as well as low-dose glucorticoid treatment may enhance FSH synthesis and secretion. 24,25 The combination of reduced androgen concentrations and augmented FSH secretion may induce responsiveness of drugs in a previous nonresponder. It is not only effective in hyperandrogenic women 6,7,24,26 but also has been shown to be effective in CC resistant women with normal levels of DHEAS.…”

Section: Discussionmentioning

confidence: 99%

“…A number of authors shown that effectiveness of clomiphene citrate were improved when the circulating androgen levels were suppressed with glucocorticoids. 6,7,[24][25][26][27] Even in hyperandrogenic women unresponsive to clomiphene citrate, pretreatment with glucocorticoids to suppress androgen levels results in establishment of an ovulatory response to clomiphene citrate. 26 Same happened in our study though initial ovulation inducing agent was letrozole instead of clomiphene citrate.…”

Section: Discussionmentioning

confidence: 99%

“…Trott et al reported success with follicular phase dexamehasone (D3-D12) in CC resistant women with normal DHEAS levels. 25 We kept same patients as control and experimental to avoid the effect of confounding variables like age, BMI, etc. One hundred and eighty-two (65%) patients produced mature follicle by D16 when we added glucocorticoids in next cycle.…”

Section: Discussionmentioning

confidence: 99%

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

Begum¹,

Siddiqui²,

Baby³

et al. 2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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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.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Begum¹,

Siddiqui²,

Baby³

et al. 2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Dexamethasone therapy during the follicular phase has been described without any side effects or serious events (114). Parsanezhad et al, 2002 (115) in a double-blind RCT, showed the safety and the efficacy of a high-dose short course of dexamethasone for inducing ovulation in 230 CC-resistant patients with PCOS and normal DHEAS levels.…”

Section: Dexamethasone Therapymentioning

confidence: 99%

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

Hashim¹

2012

Polycystic Ovary Syndrome

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Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation

Brown

Farquhar

Beck³

et al. 2005

Cochrane Database of Systematic Reviews

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Ovulation induction in clomiphene-resistant anovulatory women with normal dehydroepiandrosterone sulfate levels: beneficial effects of the addition of dexamethasone during the follicular phase

Cited by 37 publications

References 4 publications

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

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

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

Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation

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