Use of dexamethasone and clomiphene citrate in the treatment of clomiphene citrate-resistant patients with polycystic ovary syndrome and normal dehydroepiandrosterone sulfate levels: a prospective, double-blind, placebo-controlled trial.
OBJECTIVE
To evaluate the effects of short-course administration of dexamethasone (DEX) combined with clomiphene citrate (CC) in CC-resistant patients with polycystic ovary syndrome (PCOS) and normal DHEAS levels.


METHODS
Prospective, double-blind, placebo-controlled, randomized study.


METHODS
Referral university hospitals.


METHODS
Two hundred thirty women with PCOS and normal DHEAS who failed to ovulate after a routine protocol of CC.


METHODS
The treatment group received 200 mg of CC from day 5 to day 9 and 2 mg of DEX from day 5 to day 14 of the menstrual cycle. The control group received the same protocol of CC combined with placebo.


METHODS
Follicular development, hormonal status, ovulation rate, pregnancy rate.


RESULTS
Mean follicular diameters were 18.4124 +/- 2.4314 mm and 13.8585 +/- 2.0722 mm for the treatment and control groups, respectively. Eighty-eight percent of the treatment group and 20% of the control group had evidence of ovulation. The difference in the cumulative pregnancy rate in the treatment and control groups was statistically significant.


CONCLUSIONS
Hormonal levels, follicular development, and cumulative pregnancy rates improved with the addition of DEX to CC in CC-resistant patients with PCOS and normal DHEAS. This regimen is recommended before any gonadotropin therapy or surgical intervention.
Parsanezhad
Mohammad Ebrahim
ME
Division of Infertility, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. parame@sums.ac.ir
Alborzi
Saaid
S
Motazedian
Shahdokht
S
Omrani
Gholamhossein
G
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006128:Growth; D006801:Humans; D006080:Ovarian Follicle / Q000503:physiopathology*; D010060:Ovulation; D010919:Placebos; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012016:Reference Values
D005300:Fertility Agents, Female; D005938:Glucocorticoids; D010919:Placebos; D002996:Clomiphene; D019314:Dehydroepiandrosterone Sulfate; D003907:Dexamethasone