Hexia Xia1,2, Xiaoli Sun3, Haiyun Guan1,2, Ruixiu Zhang4, Wei Zhang1,2. 1. Department of Reproductive Endocrinology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China. 2. Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China. 3. Affiliated Hospital of Nantong University, Nantong, China. 4. Department of Gynaecology, Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China.
Abstract
OBJECTIVE: To identify predictors of the ovarian response to clomiphene citrate (CC) in infertile patients with polycystic ovary syndrome (PCOS). METHODS: We performed a prospective cohort study of infertile patients with PCOS. The participants underwent assessments of their physical, endocrine, and metabolic characteristics, and treatment with CC at an initial dose of 50 mg/day and a maximum of 100 mg/day between days 3 and 7 of their menstrual cycles. Participants who ovulated were identified as responders and those who did not as non-responders. RESULTS: Of the 72 participants, 48 (66.7%) were identified as responders and 24 as non-responders. Sex hormone-binding globulin (SHBG) (odds ratio 1.022, 95% confidence interval: 1.000-1.045) was found to be associated with the ovarian response to CC using logistic multivariate regression analysis. Receiver operating characteristic analysis also showed that SHBG was a significant predictor of the response to CC (area under the curve 0.799). CONCLUSION: We have shown that SHBG is the best prognostic indicator of an ovulatory response to CC. However, larger prospective studies, in which more variables are assessed, are required to confirm this finding and to identify appropriate cut-off values.
OBJECTIVE: To identify predictors of the ovarian response to clomiphene citrate (CC) in infertile patients with polycystic ovary syndrome (PCOS). METHODS: We performed a prospective cohort study of infertile patients with PCOS. The participants underwent assessments of their physical, endocrine, and metabolic characteristics, and treatment with CC at an initial dose of 50 mg/day and a maximum of 100 mg/day between days 3 and 7 of their menstrual cycles. Participants who ovulated were identified as responders and those who did not as non-responders. RESULTS: Of the 72 participants, 48 (66.7%) were identified as responders and 24 as non-responders. Sex hormone-binding globulin (SHBG) (odds ratio 1.022, 95% confidence interval: 1.000-1.045) was found to be associated with the ovarian response to CC using logistic multivariate regression analysis. Receiver operating characteristic analysis also showed that SHBG was a significant predictor of the response to CC (area under the curve 0.799). CONCLUSION: We have shown that SHBG is the best prognostic indicator of an ovulatory response to CC. However, larger prospective studies, in which more variables are assessed, are required to confirm this finding and to identify appropriate cut-off values.
Authors: K J Mather; A E Hunt; H O Steinberg; G Paradisi; G Hook; A Katz; M J Quon; A D Baron Journal: J Clin Endocrinol Metab Date: 2001-11 Impact factor: 5.958