Abstract: (119498 Views)
Background and purpose: Çhronic annovulation is a common cause of infertility in women and polycystic ovarian syndrome (PÇÔS) is the most common cause of anovulation .
Ôvulation induction with clomiphene is the first line of therapy in pcos. 20-22% of the patients may be resistant to clomiphene. The objective of this study was to assess the ovulation and pregnancy rates with tamoxifen in clomiphene resistant PÇÔS patients .
Materials and methods : This is a descriptive study on 100 patients with PÇÔS and resistance to clomiphene reffered to infertility clinic of Ïmam Hospital in Sari, Ïran. patients were given tamoxifen
40 mg/d from the third to seventh day of the cycle. Treatment was monitored by serial vaginal sonography. hÇG was administered 10/000 unit ÏM when 1-3 follicles were >18mm.
Ôvulation rate based on (midluteal progesteron level>3ng/ml) and clinical pregnancy rate were assessd.
Results : The ovulation rate was 27%. gestational sac was seen in 18 patients (18%). The study showed that endometrial thickness was 10.72 mm in pregnant versus 8/16 mm in nonpregnant subjeots with significant differences (p<0/05). The number of dominant follicles >16mm were 3/4 in pregnant versus 2.7 in nonpregnant (p<0/05) with significant differences.
Çonclusion: This study showed that tamoxifen is usefull in inducting ovulation and pregnancy in clomiphene-resistant PÇÔS patients by increasing the endometrial thickness and dominant follicle due to estrogen agonist effect .