Predictors of Ovarian Response During Clomiphene Citrate Ovulation Induction in Patients With Polycystic Ovary Syndrome
Predictors of Ovarian Response During Clomiphene Citrate Ovulation Induction in Patients With Polycystic Ovary Syndrome
The purpose of this study is to determine whether Visceral fat area and other criteria
 assessed during initial screening could predict the response to ovulation induction with
 clomiphene citrate (CC) in patients with polycystic ovary syndrome (PCOS).
The study was carried out on 150 patients with PCOS. Initial CC doses were 50 mg daily for 5
 days starting on cycle day 3. In the case of an absent response, doses were increased to 100
 and 150 mg daily in subsequent cycles. First ovulation with CC was used as the end
 point.Statistical methods Distribution of characteristics in patients is presented as the
 mean ± SD. We used the Mann-Whitney U test for exploratory comparison of initial parameters
 between responders and nonresponders. The univariate and multivariate relation with response
 to CC was assessed using logistic regression analysis. Backward stepwise elimination was used
 for the multivariate logistic analysis of prediction of patients being CRA, and P < 0.10 was
 used as a cut-off level for elimination of non-significant predictors from the prognostic
 model. The area under the receiver operating characteristics (ROC) curve (AUC) was used to
 assess the discriminative ability of the logistic models. SPSS with statistical package
 version 17 (SPSS Inc., Chicago, IL) and MedCalc Software version 12.4, (Ostend, Belgium) were
 employed for data analysis.
Inclusion Criteria:

 -  The study included 150 infertile women(age from 18 to 40 years) with PCOS diagnosed by
 the presence of at least two of the following [15]:

 1. Clinical hyperandrogenism: Hirsutism or acne vulgaris and/or biochemical
 hyperandrogenism (total testosterone >88 ng/dl or DHEAS >275 ug/dL)[16]. (2)
 Menstrual and/or ovulatory disturbances, mainly oligomenorrhea (interval between
 vaginal bleeding >35 days and < 6 months) or amenorrhea (bleeding interval >6
 months). (3) Polycystic ovaries as visualized by transvaginal ultrasound (either
 12 or more follicles measuring 2-9 mm in diameter or increased ovarian volume >10
 cm3).

 Exclusion Criteria:

 -  Patients having one or more of these criteria were excluded; Age <18 years or >40
 years, body mass index (BMI) <18.5 kg/m2 or >35 kg/m2, pregnancy, endocrine disorders,
 systemic disease, current or previous (within the last 3 months) use of oral
 contraceptives, glucocorticoids, antiandrogens, ovulation induction or dopaminergic
 agents, use of antidiabetes, antiobesity drugs or history of tubal or ovarian surgery.