الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Clomiphene citrate (CC) is the traditional first-line treatment for chronic anovulation that characterizes polycystic ovary syndrome (PCOS). CC is accumulated in the body with low clearance rate and long half-life (5 days).
Significant plasma concentrations of the active zu isomer of CC can be detected up to 6 weeks after administration. However, 20-25% of PCOS women fail to ovulate with incremental doses of CC. In addition, clinical data revealed a discrepancy between ovulation rates (75–80%) and conception rates (30–40%) during CC treatment. For these patients who do not respond to CC, there are a few limited adjunctive therapies that can be tried before moving on to gonadotrophin therapy or laparoscopic ovarian drilling including bromocriptine (in the presence of hyperpolactinaemia or galactorrhea), insulin sensitizers to treat hyperinsulinaemia, oral contraceptives (for pretreatment suppression of LH), pulsatile GnRH (to preserve physiological interactive feedback) and extended doses of CC. However, their usefulness is limited to specific abnormalities, and many women with CC resistance do not present with any overt signs of a treatable disorder. The use of corticosteroid for the treatment of ovulatory dysfunction was first reported in 1953, in 1996 Dexamethazone therapy during the follicular phase has been described without any side effects or serious sequelae and in 2002 was reported the novel use of the dexamethazone (DEX) (high dose, short course) for inducing ovulation in anovulatory 0women with PCOS and normal dehydroepiandrosterone sulphate (DHEAS).
The aim of the present study was to compare the efficacy of three different regimens of clomiphene citrate in the treatment of patients with polycystic ovary syndrome resistant to the 100 mg dose of clomiphene citrate.
The study was conducted on 63 polycystic ovary syndrome patients attended El-Shatby University Maternity Hospital with the following:
Inclusion criteria:
1. Polycystic ovary syndrome (PCOS) diagnosis according to the Rotterdam criteria.
2. Age from 19 to 35 years old.
3. No ovulation following a regimen of clomiphene citrate 100mg for 5 days (starting from day 3.
Exclusion criteria:
1. Other causes of infertility than PCOS.
2. Other endocrinal disorders.
Patients were allocated to one of the following three groups:
1. Group (A): including 20 PCOS