Follicular phase dexamethazone administration in polycystic ovarian syndrome patients who are clomiphene citrate resistant

Aim of the work

To compare the effect of adding short course follicular phase dexamethazone to clomiphene citrate versus increasing clomiphene citrate dose in cases of resistance.

Materials and methods

The study was conducted on 85 with polycystic ovary syndrome who were resistant to 150 mg clomiphene citrate daily for 5 days for 3 months and were attending El Shatby Maternity University Hospital in the period between September 2011 and May 2013. These patients were randomly allocated by closed envelope method into one of the two groups: Group I: 44 patients received 200 mg daily of clomiphene citrate from day 3 and for 5 days together with 2 mg dexamethazone daily from day 3 and for 10 days. Group II: 41 patients received 200 mg daily of clomiphene from day 3 and for 5 days.

Results

We found that a significant higher rate of ovulation was reported in the dexamethazone group compared to clomphine citrate only group, endometrial thickness was more favorable in dexamethazone group than the other group, mid luteal serum progesterone was a higher level in dexamesathone group compared to the other group and serum pregnancy rate was higher in dexamethazone group than the other group.

Conclusion

Although the mechanism underlying the beneficial effects of dexamesathone is not exactly understood, it is apparent from our data that dexamesathone therapy during the follicular phase can enhance follicular development and ovulation. Dexamethazone (corticosteroids) therapy combined with clomphine citrate can improve folliculogenesis, ovulation, and pregnancy rate in clomphine citrate resistant polycystic ovary syndrome.