Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
Fertil Steril. 2015 Mar;103(3):675-9. doi: 10.1016/j.fertnstert.2014.12.088. Epub 2015 Jan 7.
To determine the ovulation rate after ovulation induction with clomiphene citrate (CC) in women who had previously been ovulatory after a stair-step (CC-SS) ovulation induction.
Retrospective cohort.
University-based tertiary fertility center.
PATIENT(S): 61 anovulatory patients <40 years of age with polycystic ovary syndrome who underwent ovulation induction with a CC-SS protocol and a subsequent CC cycle.
INTERVENTION(S): Ovulation induction with CC.
MAIN OUTCOME MEASURE(S): Ovulation rates and cycle characteristics.
RESULT(S): Of 61 patients who underwent a subsequent CC cycle, 15 (25%) failed to ovulate at the previously ovulatory dose. Of those 15 patients, 13 (86.7%) ovulated after an increase in dose. The total number of follicles ≥15 mm (2.8 ± 1.2 vs. 1.6 ± 0.7) and peak estradiol (E2) levels (604 ± 272 pg/mL vs. 447 ± 218 pg/mL) were statistically significantly higher in the CC-SS cycle compared with the subsequent CC cycle, respectively. The endometrial lining was statistically significantly thinner in the CC-SS than the CC cycle (7.8 ± 1.8 vs. 9.2 ± 2.7, respectively).
CONCLUSION(S): The majority of patients who ovulate after a CC-SS protocol will ovulate after taking the previously ovulatory CC dose in a subsequent cycle. Those who do not ovulate will likely ovulate with a further increase in CC dose.
确定曾接受过逐步递增克罗米芬（CC）诱导排卵的女性在接受 CC 诱导排卵后的排卵率。
回顾性队列研究。
基于大学的三级生育中心。
61 名年龄<40 岁的患有多囊卵巢综合征的无排卵患者，他们接受了 CC-SS 方案的诱导排卵和随后的 CC 周期治疗。
CC 诱导排卵。
排卵率和周期特征。
在 61 名接受随后 CC 周期治疗的患者中，有 15 名（25%）在先前的排卵剂量下未能排卵。在这 15 名患者中，有 13 名（86.7%）在增加剂量后排卵。≥15mm 的卵泡总数（2.8±1.2 比 1.6±0.7）和峰值雌二醇（E2）水平（604±272pg/mL 比 447±218pg/mL）在 CC-SS 周期中均显著高于随后的 CC 周期。与 CC 周期相比，CC-SS 周期的子宫内膜衬里明显更薄（分别为 7.8±1.8 比 9.2±2.7）。
大多数在 CC-SS 方案后排卵的患者将在随后的周期中服用先前的排卵剂量后排卵。那些未排卵的患者可能会因 CC 剂量的进一步增加而排卵。
