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Human Reproduction, Vol. 14, No. 11, 2700-2703, November 1999
© 1999 European Society of Human Reproduction and Embryology

High ovulatory rates with use of troglitazone in clomiphene-resistant women with polycystic ovary syndrome

M.F.M. Mitwally, N.K. Kuscu and T.M. Yalcinkaya1

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, School of Medicine, West Virginia University Health Sciences Center, 830 Pennsylvania Avenue, Suite 304, Charleston, WV 25302, USA

This preliminary report reviews our experience with 18 infertile patients with clomiphene-resistant polycystic ovary syndrome (PCOS). In the first treatment cycle, troglitazone was administered alone. During cycles 2–5, clomiphene was added with increments of 50 mg (up to 200 mg/day) if the previous cycle was anovulatory. Basal body temperature charts and serum progesterone were obtained to confirm ovulation. In a total of 66 treatment cycles, ovulation occurred in 44 (67%) and pregnancy in seven (11%). There were no significant changes in body weight, waist:hip ratio or liver enzymes during treatment. Troglitazone, alone or with clomiphene, induced ovulation in 15 of 18 patients (83%) and seven (39%) of them achieved pregnancy. This is the first report on ovulatory rates in clomiphene-resistant women with PCOS when troglitazone was used alone or with clomiphene. Recently, metformin and clomiphene were successfully used in women with PCOS. However, our patients represent a more resistant population of women with PCOS, with each patient serving as her own historical control by previous resistance to clomiphene. Although the pregnancy rate (39%) was promising for clomiphene-resistant women with polycystic ovary syndrome, it does not seem to have a definite advantage over gonadotrophins.

Key words: clomiphene-resistant/ovulatory rate/polycystic ovary syndrome/troglitazone

1 To whom correspondence should be addressed


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