Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation)
Background: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurem...
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| Format: | Article |
| Language: | English |
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IMR Press
2022-02-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902039 |
| _version_ | 1828791372272893952 |
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| author | Theeraporn Areetheerapas Artitaya Singwongsa Komsun Suwannarurk Junya Pattaraarchachai |
| author_facet | Theeraporn Areetheerapas Artitaya Singwongsa Komsun Suwannarurk Junya Pattaraarchachai |
| author_sort | Theeraporn Areetheerapas |
| collection | DOAJ |
| description | Background: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurements. Methods: A retrospective case-control study was done over a period of three years. A total of 260 women with WHO group II anovulatory related infertility treated with clomiphene citrate 100 mg/d for five consecutive days were enrolled. 173 women were categorized in clomiphene citrate resonsive group (CCR), defined as patients with at least one dominant follicle ≥17 mm or at least 2 dominant follicles ≥15 mm. 87 women were categorized in the non-ovulatory group (NCCR), defined as patients who not meet the responsive group criteria. Various clinical, metabolic, hormonal and ultrasound features were compared between two groups. Logistic regression analysis was used to analyze the significant factors. Results: Among all participants, the mean age was 32.6 ± 4.0 years. The mean body mass index in CCR and NCCR group was 23.9 ± 10.7 kg/m2 and 24.0 ± 4.0 kg/m2, respectively. The mean waist-hip ratio (WHR) of the NCCR group was higher than that of the CCR group, i.e., 0.83 ± 0.06 vs 0.81 ± 0.05 (p = 0.004). The waist-hip ratio was the most sensitive anthropometric predictor of non-responsiveness to clomiphene: cut-off value of 0.775 (90.8% sensitivity and 20.2% specificity) and cut-off value of 0.805 (73.6% sensitivity and 42.2% specificity). Age, clinical hyperandrogenism, polycystic ovarian morphology, low antral follicle count (≤5 follicles), baseline follicle-stimulating hormones and estradiol levels were not significantly different. Conclusions: The waist-hip ratio is a clinically useful parameter in predicting clomiphene responsiveness in normogonadotropic anovulatory women (WHO group II anovulation). |
| first_indexed | 2024-12-12T02:51:01Z |
| format | Article |
| id | doaj.art-5526fd86a64242bb9fad04236d6a803c |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-12-12T02:51:01Z |
| publishDate | 2022-02-01 |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-5526fd86a64242bb9fad04236d6a803c2022-12-22T00:40:54ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-02-014923910.31083/j.ceog4902039S0390-6663(22)01688-8Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation)Theeraporn Areetheerapas0Artitaya Singwongsa1Komsun Suwannarurk2Junya Pattaraarchachai3Department of obstetrics and gynecology, Thammasat University Hospital, 12120 Pathum Thani, ThailandDepartment of obstetrics and gynecology, Ramathibodi Hospital, Mahidol University, 10400 Bangkok, ThailandDepartment of obstetrics and gynecology, Thammasat University Hospital, 12120 Pathum Thani, ThailandChulabhorn International College of Medicine, Thammasat University, 12120 Pathum Thani, ThailandBackground: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurements. Methods: A retrospective case-control study was done over a period of three years. A total of 260 women with WHO group II anovulatory related infertility treated with clomiphene citrate 100 mg/d for five consecutive days were enrolled. 173 women were categorized in clomiphene citrate resonsive group (CCR), defined as patients with at least one dominant follicle ≥17 mm or at least 2 dominant follicles ≥15 mm. 87 women were categorized in the non-ovulatory group (NCCR), defined as patients who not meet the responsive group criteria. Various clinical, metabolic, hormonal and ultrasound features were compared between two groups. Logistic regression analysis was used to analyze the significant factors. Results: Among all participants, the mean age was 32.6 ± 4.0 years. The mean body mass index in CCR and NCCR group was 23.9 ± 10.7 kg/m2 and 24.0 ± 4.0 kg/m2, respectively. The mean waist-hip ratio (WHR) of the NCCR group was higher than that of the CCR group, i.e., 0.83 ± 0.06 vs 0.81 ± 0.05 (p = 0.004). The waist-hip ratio was the most sensitive anthropometric predictor of non-responsiveness to clomiphene: cut-off value of 0.775 (90.8% sensitivity and 20.2% specificity) and cut-off value of 0.805 (73.6% sensitivity and 42.2% specificity). Age, clinical hyperandrogenism, polycystic ovarian morphology, low antral follicle count (≤5 follicles), baseline follicle-stimulating hormones and estradiol levels were not significantly different. Conclusions: The waist-hip ratio is a clinically useful parameter in predicting clomiphene responsiveness in normogonadotropic anovulatory women (WHO group II anovulation).https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902039clomiphene responseanovulatory infertilityovulation induction |
| spellingShingle | Theeraporn Areetheerapas Artitaya Singwongsa Komsun Suwannarurk Junya Pattaraarchachai Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) Clinical and Experimental Obstetrics & Gynecology clomiphene response anovulatory infertility ovulation induction |
| title | Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) |
| title_full | Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) |
| title_fullStr | Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) |
| title_full_unstemmed | Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) |
| title_short | Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation) |
| title_sort | predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation who group ii anovulation |
| topic | clomiphene response anovulatory infertility ovulation induction |
| url | https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902039 |
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