Comparison between Clomiphene Citrate / Metformin Stair Step Protocol and Traditional Protocol in Treatment of Polycystic Ovary | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Article 8, Volume 28, Issue 1 - Serial Number 11106352, January 2024, Pages 57-64 PDF (3.26 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2024.345941 | ||
| Authors | ||
| Waleed F. Ghareeb1; Nourhan Ez-Eldeen Ahmed* 2, 3; Elham H. Madny4; Osama E. Ashour5, 6 | ||
| 11. Assistant professor of Obstetrics & Gynecology, Faculty of Medicine-Suez Canal University, Ismailia, Egypt | ||
| 2Resident of Obstetrics & Gynecology, Faculty of Medicine-Suez Canal University, Ismailia, Egypt | ||
| 3M.B.B.CH 2018, Suez Canal University, Resident of Obstetrics & Gynecology, Faculty of Medicine, Suez Canal University Hospitals, Ismailia, Egypt | ||
| 4Professor of Obstetrics & Gynecology, Faculty of Medicine-Suez Canal University, Ismailia, Egypt | ||
| 5Lecturer of Obstetrics & Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt | ||
| 6Department of obstetrics and gynecology, faculty of medicine, Suez Canal University Hospital, Ismailia, Egypt | ||
| Abstract | ||
| Background: As Clomiphene citrate (CC) is widely used in treatment of infertility in polycystic ovarian syndrome (PCOS). Aim: To evaluate rate of ovulation using CC “stair step protocol” compared to “traditional protocol”. Methods: A randomized clinical trial conducted on 60 infertile PCO were randomly divided to 2 groups, group (A) “Stair Step protocol” in which CC was administrated on day 2 to day 6 of menses then transvaginal ultrasound (TVUS) was done, if follicular diameter less than 18 mm on day 14 increasing dose to 100 mg days for further 5 days, then TVUS on day 21, if no response, an increasing the dose to 150 mg daily. In group (B), “Traditional protocol” started with CC 50 mg on day 2 to day 6 of menses, if no response, in subsequent cycles the dose increased by 50 mg till dose 150 mg daily. Metformin dose was 500mg daily then increased weekly by 500 mg till 1500 mg daily. Results: the rate of ovulation and pregnancy were higher in the stair-step than the traditional group (76.7 vs. 63.3 %, respectively) (40 vs. 26.7 %, respectively). With significantly shorter duration of treatment was in stair-step than traditional protocol (21 ± 7.0 vs. 49 ± 24 days, respectively). Conclusion: the stair step protocol has a higher efficacy than traditional protocol. Synopsis: stair step protocol has higher ovulation and pregnancy rate and significant shorter duration of treatment making it superior on traditional protocol. | ||
| Keywords | ||
| Keywords: Clomiphene citrate; metformin; ovulation; stair-step | ||
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