Polycystic Ovary Syndrome

Women's Corner - Syndromes
Polycystic Ovary Syndrome

By: Abdel-Maguid Ismail Ramzy, M.D.
Ass. Prof. Of Obstetrics and Gynaecology, Cairo University.
Consultant R

Clomiphene

Clomiphene (CC) is one of the effective medications, financially and medically, that can be used for ovulation induction. These are molecularly similar in structure to estrogens and work on the estrogen receptors in the hypothalamus and the pituitary gland to increase FSH secretion. It has been found to increase the increase the insulin growth factor binding proteins thus limiting the insulin resistence at the ovarian level. It increases the SHBG levels. It is taken orally during the early days of the cycle. In cases of PCOS who do not have other causes of infertility, it is estimated that about 80% may achieve ovulatory cycles and may become pregnant over a six months period. The usual daily dose of 100 mg should not be surpassed except if proven ineffective to induce ovulation. One thing a physician should avoid is super stimulate a polycystic ovary. If after reasonable period of time CC treatment proved ineffective, even with increased doses and length of treatment, gonadotrophins may be used. These are more expensive and are associated with more side effects and complications. Urinary gonadotrophins, purified FSH and recombinant FSH can be used and are ascendingly expensive. Up-to-date medical literature did not clear cut ascending effectiveness of these preparation in achieving higher pregnancy rates. The role of the physician in this respect is to tailor the treatment modalities according to each patient. Medical, financial, and other factors play a detrimental role in the treatment strategy advocated by the physician. The patient should share in her treatment strategy. Both the patient and the physician should discuss options and complications openly.

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