連續兩月服用排卵藥
第二個月應考慮提高排卵藥劑量以提高排卵率

Fertil Steril. 2015 Mar;103(3):675-9. doi: 10.1016/j.fertnstert.2014.12.088. Epub 2015 Jan 7.

Ovulation rate and cycle characteristics in a subsequent clomiphene citrate cycle after stair-step protocol.

Budinetz TH1, Benadiva CA1, Griffin DW1, Engmann LL1, Nulsen JC1, DiLuigi AJ2.

Author information

Abstract

OBJECTIVE:

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.

DESIGN:

Retrospective cohort.

SETTING:

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.