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Akbari Asbagh F,
Volume 58, Issue 3 (7 2000)
Abstract

Clomiphene critrate is an effective and safe treatment for anovulation, but in some cases resistance occurs. To evaluate the efficacy of Dexamethasone in resistant anovulatory normal Dehydroepiandrosterone patients, we prospectively studied 57 infertile resistant anovulatory women. Each woman received 100 mg daily clomiphene critrate from cycle days 3-7 and 0.5 mg Dexamethasone from cycle days 3-12 at night. Serial ultrasonography was performed and hCG (5000-10000 IU) was administered when the follicles reached 17-18 mm in diameter. Ovulation in 80.7% and clinical pregnancy in 29.3% patients were achieved in 92 treatment cycles. The average dominant follicles>16.1 mm was 2.42. The endometrium thickness in 61.4% was greater than 8 mm. Nor adverse reaction of clomiphene critrate neither hyperstimulation were encountered. Ovulation and pregnancy rates were similar in both primary and secondary infertile groups. According to low cost, less side effects and effectiveness, we recommend combination of clomiphene critrate and Dexamethasone in patients with normal DHEAS resistant anovulation.
Akbari Asbagh F,
Volume 59, Issue 1 (7 2001)
Abstract

The objective of this study was to examine the correlation between both midfollicular FSH/LH ratio and number(s) of follicles with ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovarian syndrome (PCOS). This was carried out in IVF unit at Mirza Kouchak Khan Hospital. To induce ovulation, PCOS patients were stimulated with gonadotropines. Fifty four PCOS patients with normal basal level of FSH, LH were studied prospectively. 22 patients did not receive HCG and stimulation cycle was canceled due to OHSS. 32 patients received HCG and stimulation cycle was completed. In all patients mid-follicular (day 8 of stimulation protocol) serum FSH/LH ratio was measured. On the same day number of ovarian follicles were also counted using vaginal sonography. In canceled cycles, LH on day 8 was shown to be low along with increased number of follicles. The risk of cycle cancelation raised twice with one increment of FSH/LH ratio. Also, with increase of one follicle the risk of cycle cancellation increased 1.3 times. To induce ovulation by gonadotropine stimulation in PCOS patients, the dose should be carefully monitored. Measuring FSH/LH ratio and number of follicles on day 8 of stimulation protocol are reliable guides in order to predict those patients prone to develop OHSS.

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