Does adding dexamethasone to clomiphene citrate improve ovulation in PCOS patients? a triple - blind randomized clinical trial study

ABSTRACT

A common cause of anovulation is polycystic ovarian syndrome [PCOS]. Clomiphene citrate [CC] is the first line of treatment in PCOS patients however approximately 25% of patients may be CC-resistant. This study aimed to evaluate the efficacy of adding dexamethasone [dex] to CC in CC-resistant PCOS patients with the intent to improve ovulation. This randomized controlled trial study was performed on 60 infertile PCOS patients referred to our infertility research center from 2007 to 2009. Patients were randomly divided in two groups and stimulation performed with dex+CC or CC+placebo. Rates of ovulation, pregnancy and number of mature follicles were evaluated. Ovulation rate in the dex+CC group was 21 out of 30 [70%] and in the CC+placebo group it was 17 out of 30 [56.7%]. The pregnancy rate was 5 [16.7%] in the dex+CC group and 3 [10%] in the CC+placebo group. There was no significant difference between rates of ovulation and pregnancy in both groups, but the number of follicles >/= 18 mm were significant in the dex+CC group [p<0.05]. Our results showed that addition of dex to CC significantly increased the number of matured follicles, however the ovulation and pregnancy rates were comparable between the two groups