Improving pregnancy rate in infertile patients with polycystic ovarian syndrome receiving clomiphene citrate and cabergoline in euprolactinomic women in single cycle treatment.

OBJECTIVES: To assess the therapeutic efficacy of cabergoline when given routinely with clomiphene citrate (CC) in infertile women with polycystic ovarian syndrome (PCOS) and normal serum prolactin in single cycle therapy.

MATERIAL AND METHODS: This prospective study included a total of 110 infertile women with polycystic ovaries and normal serum prolactin divided into two groups. The first group received only a single cycle clomiphene citrate 100 mg in two divided doses (50 mg × 2) from Day 2 to Day 6. The second group received the same regimen of clomiphene citrate along with cabergoline in two divided doses of 0.5 mg each week at Day 2 and Day 9, respectively. All patients were evaluated through full history and physical examination. Blood was extracted from all patients for hormonal assay and ultrasound for the assessment of ovulation.

RESULTS: The success rate of ovulation induction was statistically significant. Biochemical pregnancy elevated to (36.0%, n = 18) with using combined drugs while it was 14.0%, n = 7, with the use of clomiphene citrate alone (p = 0.011). The clinical pregnancy rate in the study group was elevated to 32.0%, n = 16, which is statistically significant. No significant association was found between abortion and the type of treatment. There were no significant differences between the groups regarding drug side effect like ovarian hyper stimulation rate, multiple pregnancy rate as well as other adverse effects.

CONCLUSIONS: Adding cabergoline in small doses together with clomiphene citrate in PCOS infertile women and normal serum prolactin increases the success rate of ovulation & significantly improves pregnancy rate with minimal drug side effects.