Omer Alaa Abdelaal Hassan, Nabag Wisal Omer Mohamed
Department of Obstetrics and Gynecology, Sudan Medical Specialization Board, Khartoum, Sudan (Dr Omer).
Department of Obstetrics and Gynecology, Alzaiem Alazhari University, Khartoum North, Sudan (Dr Nabag).
AJOG Glob Rep. 2023 Feb 9;3(3):100173. doi: 10.1016/j.xagr.2023.100173. eCollection 2023 Aug.
Polycystic ovary syndrome is an anovulatory infertility problem that requires the treatment of ovulation induction. Clomiphene citrate is a first-line regimen for ovulation induction. The antimüllerian hormone is produced by granulosa cells of small, growing follicles in the ovary. Folliculogenesis is an essential process for ovarian function. Endometrial thickness is important throughout a female's life, especially concerning medications for ovulation induction.
This study aimed to determine the role of basal antimüllerian hormone and midcycle endometrial thickness in predicting follicular maturation and pregnancy in patients with polycystic ovary syndrome treated with clomiphene citrate.
This was a prospective cohort study that was conducted at El-sir Abualhassan's Fertility Center (September 2020 to August 2021). The study included 197 patients with polycystic ovary syndrome diagnosed using the Rotterdam criteria. The patients were treated with a dosage of 100 mg of clomiphene citrate. Data were collected using a questionnaire that was filled out after informed consent was provided by the patients. The basal antimüllerian hormone level was measured using enzyme immunoassay, and endometrial thickness and follicular size were measured before and after clomiphene citrate treatment using transvaginal ultrasound. The data were analyzed using SPSS (version 23; IBM Corporation, Armonk, NY). Moreover, the correlation was performed using the chi-square test.
Almost two-thirds of the participants have normal antimüllerian hormone levels. Before clomiphene citrate was used as the treatment regimen, 95.40% of the patients had an endometrial thickness of ≤5 mm and a follicular size of 1 to 6 mm. After clomiphene citrate treatment, 74.60% of the patients had an endometrial thickness of 6 to 10 mm, and 46.20% of the patients had a follicular size of 7 to 12 mm. A significant correlation was found between basal antimüllerian hormone, follicular maturation, and pregnancy (=.001). There was a significant association between endometrial thickness after clomiphene citrate treatment and achieving pregnancy (=.001).
Clomiphene citrate is a first-line regimen for patients with polycystic ovary syndrome with normal antimüllerian hormone levels. After clomiphene citrate treatment, there was a correlation between antimüllerian hormone and follicular maturation and pregnancy. Moreover, there was a correlation between midcycle endometrial thickness and pregnancy.
多囊卵巢综合征是一种无排卵性不孕问题，需要进行促排卵治疗。枸橼酸氯米芬是促排卵的一线治疗方案。抗苗勒管激素由卵巢中生长中的小卵泡的颗粒细胞产生。卵泡发生是卵巢功能的重要过程。子宫内膜厚度在女性一生中都很重要，尤其是在促排卵药物治疗方面。
本研究旨在确定基础抗苗勒管激素和月经周期中期子宫内膜厚度在预测接受枸橼酸氯米芬治疗的多囊卵巢综合征患者卵泡成熟和妊娠方面的作用。
这是一项前瞻性队列研究，于艾尔 - 西尔·阿布勒哈桑生育中心进行（2020年9月至2021年8月）。该研究纳入了197例根据鹿特丹标准诊断为多囊卵巢综合征的患者。患者接受100毫克枸橼酸氯米芬的剂量治疗。数据通过患者签署知情同意书后填写的问卷收集。基础抗苗勒管激素水平采用酶免疫测定法测量，枸橼酸氯米芬治疗前后使用经阴道超声测量子宫内膜厚度和卵泡大小。数据使用SPSS（版本23；IBM公司，纽约州阿蒙克）进行分析。此外，采用卡方检验进行相关性分析。
近三分之二的参与者抗苗勒管激素水平正常。在使用枸橼酸氯米芬作为治疗方案之前，95.40%的患者子宫内膜厚度≤5毫米，卵泡大小为1至6毫米。枸橼酸氯米芬治疗后，74.60%的患者子宫内膜厚度为6至10毫米，46.20%的患者卵泡大小为7至12毫米。发现基础抗苗勒管激素、卵泡成熟和妊娠之间存在显著相关性（P =.001）。枸橼酸氯米芬治疗后的子宫内膜厚度与妊娠成功之间存在显著关联（P =.001）。
枸橼酸氯米芬是抗苗勒管激素水平正常的多囊卵巢综合征患者的一线治疗方案。枸橼酸氯米芬治疗后，抗苗勒管激素与卵泡成熟及妊娠之间存在相关性。此外，月经周期中期子宫内膜厚度与妊娠之间存在相关性。
