Clomiphene citrate improves cycle characteristics, impairs IVF outcomes
Investigators divided 174 obese women with PCOS undergoing IVF into two groups according to treatments received: those who were given CC with human menopausal gonadotropin (HMG) and medroxyprogesterone acetate (MPA; n=90), and those who received HMG and MPA only (control; n=84).
HMG dose was significantly lower in the HMG+MPA+CC group (1,650 IU) compared with the control group (2,025 IU; p=0.0002038). In contrast, HMG stimulation duration between the two groups were comparable (11 vs 12 days; p=0.077).
The number of oocytes retrieved was significantly higher in the control group than in the study group (13 vs 5; p=0.0000016), while the time from trigger to retrieval of oocytes was comparable between groups.
The control group also had significantly higher numbers of mature oocytes (11 vs 4; p=0.00000386), fertilized oocytes (8 vs 4; p=0.000081) and cleaved embryos (8.5 vs 4 p=0.0000633) compared with the HMG+MPA+CC group.
The number of high quality embryos were also significantly greater in the control group than in the study group (3.5 vs 2; p=0.003).
Recruited participants underwent transvaginal ultrasound to measure antral follicle count and follicle size. Serum concentrations of relevant hormones were also recorded. The primary study outcome was the number of oocytes retrieved, while secondary outcomes included maturation rate, number of high quality embryos and fertilization rate.