TLDR Choosing the right starting dose of Clomiphene Citrate for ovulation induction in PCOS women is challenging; higher BMI and hormone levels may indicate resistance to the standard dose.
The study involved 283 anovulatory PCOS women and aimed to identify factors that could predict resistance to the initial 50 mg/day dose of Clomiphene Citrate (CC). The results showed that 36.8% of the patients were resistant to the 50 mg/day dose. Patients who resisted this dose had significantly higher BMI, waist circumference, serum levels of AMH, total testosterone, Δ4-androstenedione, 17-OHP, and insulin, and significantly lower serum levels of SHBG. However, only AMH and SHBG were statistically significant after multivariate analysis. Despite this, the study failed to establish satisfactory thresholds for AMH and SHBG to predict resistance to a 50 mg/day dose of CC. The study concluded that identifying these factors would allow starting the treatment at a higher dose (100 mg/day) at once, saving significant time for patients who are resistant to 50 mg/day of CC.
91 citations,
December 2017 in “Systems Biology in Reproductive Medicine” Lower SHBG levels may increase the risk of PCOS.
378 citations,
November 2011 in “Human reproduction update” Experts recommend using evidence-based methods to diagnose and treat hirsutism, focusing on symptoms and underlying causes.
40 citations,
January 2010 in “Annales D Endocrinologie” The French Endocrine Society suggests diagnosing PCOS with two of three signs, recommends lifestyle changes and clomiphene for treatment, and calls for more research on certain treatments and tests.
4025 citations,
December 2003 in “Human Reproduction” The 2003 consensus updated PCOS diagnosis criteria and linked PCOS to higher risks of diabetes and heart problems, recommending lifestyle changes to lower these risks.
88 citations,
May 2012 in “Human Reproduction Update” Women with PCOS may take longer to get pregnant but can have a normal family size, and should manage their overall health to reduce long-term health risks.
343 citations,
December 2008 in “Endocrine Reviews” Metformin helps with menstrual cycles and insulin levels in PCOS but is less effective for hair growth, diabetes prevention, and weight loss, and may improve fertility and reduce diabetes risk.
6 citations,
April 2019 in “Journal of Pediatric Endocrinology and Metabolism” Metformin improved menstrual cycle regularity and signs of hyperandrogenism in adolescent girls with type 1 diabetes but did not improve blood sugar control.
July 2015 in “Cambridge University Press eBooks” The document concludes that careful history and physical exams are crucial for accurately diagnosing polycystic ovary syndrome and distinguishing it from other similar conditions.
2 citations,
February 2022 in “Frontiers in Endocrinology” Antiandrogenic pretreatment for women with PCOS does not improve fertility outcomes and delays pregnancy.