An observational analysis of clinical factors predicting ovulation induction among infertile women with Poly Cystic Ovarian Syndrome: At Tertiary care facility, Jaipur

Abstract

Objective: To identify the predictive factors for ovulation with clomiphene citrate (CC) in polycystic ovarian syndrome (PCOS) patients with infertility. Materials and Methods: A prospective observational study was carried out at the IVF centre of a teaching hospital, Jaipur between January 2019 to December 2019. Total54 patients with PCOS as per Rotterdam criteria, who attended for treatment of fertility were enrolled in the study. Patients were given clomiphene citrate in incremental doses from 50 to 150 mg per day for five days. Clinical parameters (age, duration of infertility, waist circumference, body mass index(BMI), biochemical parameters (fasting blood sugar,fasting Serum insulin, serum total testosterone, serum luteinizing hormone(LH), serum follicle stimulating hormone(FSH), antimullerian hormone(AMH) and ultrasonographic parameters - antral follicle count(AFC), ovarian volume, uterine and stromal vessels pulsatility index between ovulating and non-ovulating patients were statistically analysed. Results: Total 40.74 % patients ovulated with increasing dose of clomiphene-citrate. A statistically significant difference was observed in waist circumference, serum testosterone, LH, AMH, AFC and Ovarian stromal artery PIbetween patients who ovulated and who did not. However, no significant difference was observed with regards to patient’s age, BMI, fasting glucose, serum FSH, serum Insulin, ovarian volume and uterine artery PI. Conclusion: Factors like WC, Serum total testosterone, serum LH level, AMH, AFC and ovarian stromal artery PI could be used as tools to predict response to clomiphene-citrate in the treatment of PCOS patients. This can help clinicians in deciding more effective and patient tailored approach.