Determination of Sex Hormones, Glucose Tolerance Test and Insulin Concentrations in Prediction of Clomiphene Citrate Efficacy in Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a common disease in young women that is associated with infertility and other complications such as obesity, hirsutism and insulin resistance and also the disorder that mostly is specified with oligomenorrhoea or amenorrhea with clinical or laboratory evidence of hyperandrogenemia. The purpose of this study was to investigate whether measurements of sex hormones, Glucose Tolerance Test (GTT) and insulin serum in patients with PCOS can be useful to predict the efficacy of Clomiphene Citrate (CC). This study was targeted patients with PCOS admitted for undergoing superovulation. To determine the values of sex hormones, insulin, Fast Blood Sugar (FBS), High-Density Lipoprotein (HDL) and GTT to predict the efficacy of CC, blood samples of the cases were taken before the administration of CC. Afterwards, CC therapy was given up to 3 months and then, the cumulative pregnancy rate or improving ovulation was calculated. Ovulation, after taking CC, was done in 42.2% of the cases. However, the clinical pregnancy rate was not more significant in cases responded well to the CC therapy compared to resistant cases (P ≥ 0.387). There was a significant difference in the mean Follicle Stimulating Hormone (FSH) (P ≥ 0.0001), and Luteinizing Hormone (LH) (P ≥ 0.024) between the resistant and responder patients to CC. Moreover, GTT in resistant cases to CC was higher than responder cases (P ≥ 0.024). However, this relation, between resistant and responder cases to CC, was not meaningful in estradiol (P ≥ 0.478), insulin (P ≥ 0.882), HDL (P ≥ 0.118) and FBS (P ≥ 0.1). When all of the cases were stratified according to their Body Mass Index (BMI) (BMI ≤ 25 kg/m2 and BMI > 25 kg/m2), A significant difference was found in the ovulation (P ≥ 0.001) and rate of pregnancy (P ≥ 0.029) between the two groups (BMI ≤ 25 kg/m2 and BMI > 25 kg/m2 ). Determination of FSH, LH, GTT and BMI may produce a reliable way to predict maturation and ovulation status using CC therapy in women with PCOS.