title: Clomiphene citrate co-treatment with low dose urinary FSH versus urinary FSH for clomiphene resistant PCOS: randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to examine the effect of clomiphene citrate [CC] co-administration during the use of exogenous low-dose urinary FSH [uFSH] for induction of ovulation in CC-resistant infertile PCOS women.
  
  
  METHODS
  In a randomised controlled setting, 174 CC-resistant infertile PCOS women were randomized into two parallel groups; Group I received CC 100 mg/day for 5 days plus uFSH 37.5 IU/day while group II received only uFSH 37.5 IU /day. Subsequent increments of uFSH by 37.5 IU/day were made according to response. Primary outcome was ovulation rate. Secondary outcomes were clinical pregnancy rates, number of follicles, endometrial thickness, and gonadotropins consumption.
  
  
  RESULTS
  Our results have demonstrated that group I compared to group II had significantly higher ovulation rate per intention to treat [ITT] [72.4 % vs. 34.2 %, p < 0.001]. Clinical pregnancy and live birth rates were comparable between the two groups. Group I consumed significantly lower total FSH dose and needed significantly shorter stimulation duration compared to group II.
  
  
  CONCLUSIONS
  CC co-administered during low dose HP uFSH versus uFSH for CC-resistant PCOS yields significantly higher ovulation rate and less consumption of FSH.
authors.affiliation: Mansoura Integrated Fertility Center, Mansoura, Egypt.
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Ghanem
authors.forename: Laila A
authors.initials: LA
authors.lastname: Elboghdady
authors.forename: Mohamad
authors.initials: M
authors.lastname: Hassan
authors.forename: Adel S
authors.initials: AS
authors.lastname: Helal
authors.forename: Ahmed
authors.initials: A
authors.lastname: Gibreel
authors.forename: Maha
authors.initials: M
authors.lastname: Houssen
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Shaker
authors.forename: Ibrahiem
authors.initials: I
authors.lastname: Bahlol
authors.forename: Yaser
authors.initials: Y
authors.lastname: Mesbah
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D004338:Drug Combinations; D004351:Drug Resistance / Q000187:drug effects*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D005300:Fertility Agents, Female; D002996:Clomiphene; D005640:Follicle Stimulating Hormone