الفهرس 
POLYCYSTIC OVARIAN SYNDROMEOnly 14 pages are availabe for public view
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Abstract
Polycstic ovary syndrome is associated with chronic anovulation and is a common cause of infertility, affecting 5–10% of reproductive age women (Jeffrey et al., 2007).
Clomiphene citrate (CC) is the traditional first-line treatment for the chronic anovulation that characterizes PCOS. In addition, clinical data revealed a discrepancy in ovulation rates and conception rates During CC treatment. (Nakamura et al 1997).
This could be due to negative effects of clomiphene citrate on oocytes or granulosa cells, or because of prolonged antiestrogenic effects on the endometrium and cervical mucous. These negative effects are augmented by the relatively long half-life of clomiphene citrate, which is known to be 5 days. If treatment is started late in the cycle, those negative effects are more likely to extend into the sensitive peri-implantation period (Bilijan et al., 1999).
A longer clomiphene citrate free time during the sensitive peri-implantation period seems more promising than the traditional regimen as treatment with clomiphene citrate is associated with higher rates of pregnancy if started early in the menstrual cycle (Dehbashi et al., 2006).
The aim of this study was to compare the effect of early start of CC in late luteal phase versus the classical follicular CC for ovulation induction in women with PCOS. The study included 40 infertile women diagnosed as having PCOS, were randomized into 2 groups, 20 women who were given CC 100 mg/day for 5 days starting the next day after finishing medroxyprogesterone acetate (MPA) before withdrawal bleeding. And 20 women who were given CC 100 mg/day for 5 days starting on the day 3 of the menstrual cycle, ovulation monitoring by transvaginal ultrasonographic folliculometry was done.
Once the dominant follicle reached a size of 20 mm, the number of follicles and the endometrial thickness were assessed and hCG 10.000 IU was given intramuscular to trigger ovulation and timed intercourse was advised.
The data and results collected were tabulated and statistically analyzed.
The characteristics of the early (late luteal) CC treatment cycles showed that; on the day of hCG administration, the mean number of follicles > 20 mm was 1.417 in the early CC group, while in the late CC group it was 1.4%. The mean endometrial thickness was 10.42 mm in early CC group and 8.7 mm in the second group which was significantly thicker in early CC group. And the pregnancy rate was 15% in group I and 10% in group II with no significant statistical difference between both studied groups.