Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation)

IF 0.4 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Clinical and experimental obstetrics & gynecology Pub Date : 2022-02-09 DOI:10.31083/j.ceog4902039

Theeraporn Areetheerapas, Artitaya Singwongsa, K. Suwannarurk, J. Pattaraarchachai

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引用次数: 0

Abstract

Background: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurements. Methods: A retrospective case-control study was done over a period of three years. A total of 260 women with WHO group II anovulatory related infertility treated with clomiphene citrate 100 mg/d for five consecutive days were enrolled. 173 women were categorized in clomiphene citrate resonsive group (CCR), defined as patients with at least one dominant follicle ≥17 mm or at least 2 dominant follicles ≥15 mm. 87 women were categorized in the non-ovulatory group (NCCR), defined as patients who not meet the responsive group criteria. Various clinical, metabolic, hormonal and ultrasound features were compared between two groups. Logistic regression analysis was used to analyze the significant factors. Results: Among all participants, the mean age was 32.6 ± 4.0 years. The mean body mass index in CCR and NCCR group was 23.9 ± 10.7 kg/m and 24.0 ± 4.0 kg/m, respectively. The mean waist-hip ratio (WHR) of the NCCR group was higher than that of the CCR group, i.e., 0.83 ± 0.06 vs 0.81 ± 0.05 (p = 0.004). The waist-hip ratio was the most sensitive anthropometric predictor of non-responsiveness to clomiphene: cut-off value of 0.775 (90.8% sensitivity and 20.2% specificity) and cut-off value of 0.805 (73.6% sensitivity and 42.2% specificity). Age, clinical hyperandrogenism, polycystic ovarian morphology, low antral follicle count (≤5 follicles), baseline follicle-stimulating hormones and estradiol levels were not significantly different. Conclusions: Thewaist-hip ratio is a clinically useful parameter in predicting clomiphene responsiveness in normogonadotropic anovulatory women (WHO group II anovulation).

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促性腺激素正常无排卵(WHO II组无排卵)不孕妇女柠檬酸克罗米芬反应性的预测因素

背景:世卫组织II组无排卵患者对克罗米芬的反应性各不相同。我们的研究评估了该人群中与枸橼酸克罗米芬反应性相关的因素。研究了各种参数，包括人体测量，激素和经阴道超声测量。方法:回顾性病例对照研究，为期三年。共有260名患有世卫组织II组无排卵相关不孕症的妇女连续5天接受枸橼酸克罗米芬100 mg/d治疗。173名女性被归类为克罗米芬反应组(CCR)，定义为至少一个显性卵泡≥17mm或至少两个显性卵泡≥15mm的患者。87名女性被归类为非排卵组(NCCR)，定义为不符合反应组标准的患者。比较两组患者的临床、代谢、激素、超声等指标。采用Logistic回归分析分析显著性因素。结果:所有参与者的平均年龄为32.6±4.0岁。CCR组和NCCR组平均体重指数分别为23.9±10.7 kg/m和24.0±4.0 kg/m。NCCR组的平均腰臀比(WHR)高于CCR组，分别为0.83±0.06 vs 0.81±0.05 (p = 0.004)。腰臀比是对克罗米芬无反应性最敏感的人体测量预测指标:临界值为0.775(90.8%的敏感性和20.2%的特异性)，临界值为0.805(73.6%的敏感性和42.2%的特异性)。年龄、临床高雄激素症、多囊卵巢形态、窦腔卵泡计数低(≤5个)、基线促卵泡激素和雌二醇水平无显著差异。结论:腰臀比是预测促性腺激素正常无排卵妇女(WHO II组无排卵)克罗米芬反应性的临床有用参数。

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来源期刊

Clinical and experimental obstetrics & gynecology 医学-妇产科学

CiteScore

0.50

自引率

0.00%

发文量

241

审稿时长

1 months

期刊介绍： CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.