The role of ketoconazole in the prevention of ovarian hyperstimulation syndrome in patients with polycystic ovary syndrome during assisted reproductive technology cycles.
OBJECTIVE
To assess the clinical efficacy of ketoconazole (KCZ) as an inhibitory enzyme on ovarian steroidogenesis, in prevention of ovarian hyper- stimulation syndrome (OHSS) during assisted reproductive technology (ART) in patients with polycystic ovarian syndrome (PCOS).


METHODS
We included 58 PCOS patients, enrolled for in-vitro fertilization or intracytoplasmic sperm injection in a randomized clinical trial between November 2000 and October 2001 in the Royan Institute, Tehran, Iran. Twenty-eight patients received KCZ during the stimulation phase and 30 patients were controls. We compared serum E2 levels, number of lead follicles, number of retrieved oocytes, fertilization rate, occurrence of OHSS and cancellation rate using student's t-test, Chi-square and Fisher exact test.


RESULTS
We found no significant differences between the 2 groups in the peak serum estradiol level, the number of lead follicles, oocytes, and fertilization rate. One patient in the control group had clinical symptoms of severe ovarian hyperstimulation, and none from the treated group.


CONCLUSIONS
This study reveals no significant effect of KCZ on the incidence of OHSS during ART cycles; however, also no significant negative effects of KCZ on the number and maturity of oocytes or on fertilization rate.
Owj
Monir
M
Department of Endocrinology and Female Infertility, Royan Institute, Tehran, Iran. owje@yahoo.com
Tehrani-Nejad
Ensieh S
ES
Amirchaghmaghi
Elham
E
Baghestani
Ahamd R
AR
Ahmadi
Jila
J
D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use*; D008423:Maternal Age; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology / Q000517:prevention & control*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011336:Probability; D012016:Reference Values; D027724:Reproductive Techniques, Assisted; D018570:Risk Assessment; D016896:Treatment Outcome
D007654:Ketoconazole