[Treatment options of clomiphene-resistant polycystic ovary syndrome related infertility].

OBJECTIVE

To investigate the treatment options of clomiphene(CC)-resistant polycystic ovary syndrome (PCOS) related infertility.

METHODS

Fifty-nine PCOS patients with CC resistant-anovulation were accepted and treated by the following three protcols: (1) follicle-stimulating hormone (FSH) group, 49 cycles; (2) FSH + pulsatile gonadotropin-releasing hormone(GnRH) group, 13 cycles; (3) conventional in vitro fertilization (IVF)-embryo transfer (ET) group, 19 cycles. Suppressive treatment on serum luteinising hormone (LH) and testosterone (T) levels was given in the first and second groups in advance. Serum estradiol level; pregnancy rate; miscarriage rate, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy rate were compared among the three groups.

RESULTS

The pregnancy rate in FSH group, FSH + GnRH group and IVF-ET group were 37%, 54% and 22% respectively. The highest rate and multiple pregnancy rate was found in IVF-ET group.

CONCLUSION

The rationale treatment options for CC-resistant PCOS related infertility was the addition pre-suppressive treatment, low-dose FSH stimulated regimen subsequent pulsatile GnRH infusion. IVF were only accepted after failure with gonadotropin therapy.