Optimal Starting Dose of Clomiphene Citrate for Ovulation Induction in Anovulatory PCOS Women

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.