Study of the response of PCOS patients to clomiphene citrate based on hormonal Parameters and body mass index

Background: Our study aimed to evaluate the response of polycystic ovarian syndrome patients to clomiphene citrate based on hormonal parameters and body mass index.Methods: It is a prospective observational study that was carried out on 48 women with PCOS-related infertility. They were treated with an incremental dose of clomiphene citrate starting with 50 mg/day to a maximum of 100 mg. The response was recorded as either the presence or absence of ovulation. Hormonal parameters such as serum FSH, LH, testosterone, fasting insulin, DHEA, prolactin, and body mass index (BMI) were evaluated. The correlation of each of these parameters in predicting non-responsiveness (failure to ovulate with 100 mg clomiphene) was calculated.Results: Among 48 PCOS patients who were enrolled in the study, 14 patients responded to CC 50 mg, 26 patients responded to CC 100 mg and 8 patients were CC non-responders. We concluded that serum LH, fasting insulin, and BMI were significant predictors of response to ovulation with CC in PCOS patients.Conclusions: In our study, we concluded that among the hormonal and biochemical parameters we studied serum LH, fasting insulin, and BMI are significant predictors of response of ovulation with CC in women with PCOS-related infertility. This may help physicians to counsel and select the proper infertility treatment for women with PCOS experiencing infertility so that it should be less time-consuming and cost-effective.

Silent Thecoma of Ovary - A Rare Case.

Theca cell tumours are benign ovarian tumours. These tumours are of stromal origin. Most commonly they are seen in premenopausal and postmenopausal women. Usually they are asymptomatic and are found incidentally. Ovarian cancers can be of benign and malignant type. According to WHO classification, they are classified as epithelial, germ cell, sex cord stromal tumours and others.1 Among them epithelial ovarian cancer are most common, and the least common variety is of sex cord stromal tumours. About 1% of ovarian cancers are thecoma.2 These tumours are most commonly found in postmenopausal women however about 2% of stromal tumours occur in young girls.3 Theca cell tumours are also known as hormone producing tumours as they produce oestrogen hormone. Usually the patient presents with complaint of post-menopausal bleeding because of the oestrogen which is secreted by theca cell tumours. Imaging modalities (ultrasonography and CT scan) are of little help in differentiating thecoma from other types of ovarian tumours, because of radiological close resemblance to other tumours.4 Here we enlightened the symptomless presentation of such a huge thecoma which was diagnosed incidentally.