title: Minimal stimulation or clomiphene citrate as first-line therapy in women with polycystic ovary syndrome: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of minimal stimulation and clomiphene citrate (CC) as a first-line treatment for anovulatory infertility associated with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  One hundred and thirteen women with PCOS were selected in this randomized controlled trial. Patients received minimal stimulation protocol consisted of 5 days CC (100 mg/day) then 150 IU of highly purified uFSH on cycle day 9 (n = 58, 159 cycles) or CC only (n = 55, 153 cycles) for up to three cycles. Outcome measures were: clinical pregnancy rate per cycle, number of growing and mature follicles, serum E2, endometrial thickness at the hCG day, serum P, ovulation and miscarriage rates.
  
  
  RESULTS
  There were no differences between both groups regarding the clinical pregnancy rate per cycle and per woman (8.8% vs. 7.8 % and 24.1% vs. 21.8%; p = 0.23, p = 0.36, respectively). One twin pregnancy occurred in each group. Miscarriage rate was comparable (14.3% vs. 16.7%; p = 0.38). No differences were found regarding the number of follicles, serum P, ovulation rate, E2 and endometrial thickness at the hCG day (7.8 ± 0.5 vs. 7.6 ± 0.6 mm; p = 0.52).
  
  
  CONCLUSIONS
  Ovulation induction with minimal stimulation is not more effective than CC alone for achieving pregnancy when used as initial treatment in PCOS patients.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. hatem_ah@hotmail.com
authors.forename: Hatem
authors.initials: H
authors.lastname: Abu Hashim
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bazeed
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abd Elaal
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D010060:Ovulation / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone