Department of Reproductive Endocrinology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China.
J Int Med Res. 2021 Apr;49(4):3000605211000569. doi: 10.1177/03000605211000569.
To identify predictors of the ovarian response to clomiphene citrate (CC) in infertile patients with polycystic ovary syndrome (PCOS).
We performed a prospective cohort study of infertile patients with PCOS. The participants underwent assessments of their physical, endocrine, and metabolic characteristics, and treatment with CC at an initial dose of 50 mg/day and a maximum of 100 mg/day between days 3 and 7 of their menstrual cycles. Participants who ovulated were identified as responders and those who did not as non-responders.
Of the 72 participants, 48 (66.7%) were identified as responders and 24 as non-responders. Sex hormone-binding globulin (SHBG) (odds ratio 1.022, 95% confidence interval: 1.000-1.045) was found to be associated with the ovarian response to CC using logistic multivariate regression analysis. Receiver operating characteristic analysis also showed that SHBG was a significant predictor of the response to CC (area under the curve 0.799).
We have shown that SHBG is the best prognostic indicator of an ovulatory response to CC. However, larger prospective studies, in which more variables are assessed, are required to confirm this finding and to identify appropriate cut-off values.
确定多囊卵巢综合征（PCOS）不孕患者对枸橼酸氯米酚（CC）卵巢反应的预测因素。
我们对多囊卵巢综合征不孕患者进行了前瞻性队列研究。参与者接受了身体、内分泌和代谢特征的评估，并在月经周期的第 3 至 7 天内每天服用 50mg 至最大 100mg 的 CC 进行治疗。排卵的参与者被认定为有反应者，未排卵的参与者被认定为无反应者。
在 72 名参与者中，48 名（66.7%）被认定为有反应者，24 名被认定为无反应者。使用逻辑多元回归分析发现，性激素结合球蛋白（SHBG）（比值比 1.022，95%置信区间：1.000-1.045）与 CC 对卵巢的反应相关。受试者工作特征分析也表明，SHBG 是 CC 反应的重要预测指标（曲线下面积 0.799）。
我们已经表明，SHBG 是 CC 排卵反应的最佳预后指标。然而，需要更大的前瞻性研究来评估更多变量，以证实这一发现并确定合适的截断值。
