The number of follicles and ovarian volume in the assessment of response to clomiphene citrate treatment in polycystic ovarian syndrome.

OBJECTIVE

To evaluate whether the number of follicles and ovarian volume have any significance in evaluating the response to clomiphene citrate treatment in polycystic ovarian syndrome (PCOS).

DESIGN

A prospective study of 70 infertile women, 44 of which were diagnosed with polycystic ovarian syndrome.

MAIN OUTCOME MEASURES: Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citrate(CC).

RESULTS

Ovarian volume was significantly greater in cases with polycystic ovarian syndrome than controls. However, ovarian volume in the Clomiphene Citrate nonresponders was significantly greater than in Clomiphene Citrate responders in the polycystic ovarian syndrome group. The number of small follicles was significantly higher in cases with polycystic ovarian syndrome than controls, and in the Clomiphene Citrate nonresponder group this number was also significantly higher than in Clomiphene Citrate responders. Endocrine features of patients with polycystic ovarian syndrome revealed that Dehydroepiandrostenedione sulfate, Androstenedione, follicle stimulating and luteinizing hormone do not discriminate between patients who respond to Clomiphene Citrate and those who do not respond. However, Testosterone and luteinizing hormone levels differ significantly in responders and nonresponders.

CONCLUSIONS

Small multiple follicles (> 9) and enlarged ovarian volume (> 6.8 ml) were the most prominent transvaginal ultrasonographic features of ovaries in Clomiphene Citrate nonresponsive patients with polycystic ovarian syndrome. Higher levels of Testosterone, luteinizing hormone and significantly higher number of small follicles were associated with lack of Clomiphene Citrate response. These ultrasonographic features and laboratory assays could be clinically useful for distinguishing better the Clomiphene Citrate nonresponders from responders.