H Ali Hassan1, D El-Gezeiry, T M Nafaa, I Baghdady. 1. Obstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. hassanali@dataxprs.com.eg
Abstract
PURPOSE: To study the effect of CYP17a inhibitor, "ketoconazole," on clomiphene responsiveness in PCOS patients. METHODS: Prospective analysis was employed with the setup at Alexandria IVF/ICSI center. Ninety-seven insulin-resistant PCOS patients undergoing ovulation induction usingclomiphene citrate were randomly divided, by random number table, into two groups. The first group (n = 49) received ketoconazole (400 mg daily) till correction of metabolic syndrome followed by clomiphene (100 mg/day); the second group (n = 48) receiving clomiphene without ketoconazole pretreatment. Main outcome measures were incidence of clomiphene resistance, monofollicular response, fasting insulin/glucose ratio, serum testosterone, and pregnancy rates. RESULTS: The ketoconazole group showed significantly (p < 0.05) higher incidence of monofollicular response (38%), higher pregnancy rates, and significantly less marked antiestrogenic manifestations than did the control group. They also had significantly lower incidence of clomiphene resistance (11.6%), lower serum testosterone levels, less hyperinsulinaemia, than did the control group. CONCLUSION:Ketoconazole improved clomiphene responsivenss in PCOS patients and attenuated its untoward biological effects.
RCT Entities:
PURPOSE: To study the effect of CYP17a inhibitor, "ketoconazole," on clomiphene responsiveness in PCOSpatients. METHODS: Prospective analysis was employed with the setup at Alexandria IVF/ICSI center. Ninety-seven insulin-resistant PCOSpatients undergoing ovulation induction using clomiphene citrate were randomly divided, by random number table, into two groups. The first group (n = 49) received ketoconazole (400 mg daily) till correction of metabolic syndrome followed by clomiphene (100 mg/day); the second group (n = 48) receiving clomiphene without ketoconazole pretreatment. Main outcome measures were incidence of clomiphene resistance, monofollicular response, fasting insulin/glucose ratio, serum testosterone, and pregnancy rates. RESULTS: The ketoconazole group showed significantly (p < 0.05) higher incidence of monofollicular response (38%), higher pregnancy rates, and significantly less marked antiestrogenic manifestations than did the control group. They also had significantly lower incidence of clomiphene resistance (11.6%), lower serum testosterone levels, less hyperinsulinaemia, than did the control group. CONCLUSION:Ketoconazole improved clomiphene responsivenss in PCOSpatients and attenuated its untoward biological effects.
Authors: Mohamed Abdel-Maboud; Amr Menshawy; Elfatih A Hasabo; Mohamed Ibrahim Abdelraoof; Mohamed Alshandidy; Muhammad Eid; Esraa Menshawy; Oumaima Outani; Ahmed Menshawy Journal: PLoS One Date: 2021-07-19 Impact factor: 3.240