الفهرس Only 14 pages are availabe for public view
 |  | from | 189 |  |  |
| | | from | 189 | | |
Abstract
Clomiphene citrate is the traditional first line treatment of anovulation. However, 20-25% of cases fail to ovulate with clomiphene citrate. In addition, clinical data revealed a discrepancy between ovulation rates (75-80%) and conception rates (30-40%) during CC treatment.
Clomiphene citrate resistance was defined as failure to ovulate to a dose schedule of 200 mg/day for five days or failure of follicular maturation after receiving a dose of CC 100 mg/day for 5 days for three consecutive cycles.
After CC resistance, the next step is induction of ovulation with gonadotropins which is the standard treatment for clomiphene citrate resistance women. However, this is expensive and has added risks of ovarian hyperstimulation and multiple pregnancy.
A new regimen of clomiphene citrate with gonadotropin was used in ovulation induction with or without intrauterine insemination and superovulation in vitro fertilization with or without intracytoplasmic sperms injection; this was termed minimal stimulation protocol.
The aim of this work to compare between minimal stimulation protocol and gonadotropins in inducing ovulation in clomiphene citrate resistant patients.
The study included sixty infertile women who failed to ovulate with the usual 100 mg/day CC dose for five days for three consecutive cycles. Women were randomized into two groups. Group I, included 30 women who were given clomiphene citrate orally (100 mg/day) given from the 3rd to 7th day of the cycle and HMG 150 IU/L were given intramuscular in the day 9th of cycle. Group II, included 30 women who were given HMG intramuscular early in follicular phase,starting dose was be 75 IU, and this was increased by increments of 75 IU every 7-10 days if there was no evidence of ovarian response on ultrasonography.Ovulation was monitored using transvaginal ultrasonography and midluteal serum progesterone. Once, the dominant follicule reached a size of 18 mm or more, hCG 5000 IU was given IM to trigger ovulation.