Journal of Assisted Reproduction and Genetics

, Volume 30, Issue 11, pp 1477–1485 | Cite as

Clomiphene Citrate co-treatment with low dose urinary FSH versus urinary FSH for clomiphene resistant PCOS: randomized controlled trial

  • Mohamad E. Ghanem
  • Laila A. Elboghdady
  • Mohamad Hassan
  • Adel S. Helal
  • Ahmed GibreelEmail author
  • Maha Houssen
  • Mohamed E. Shaker
  • Ibrahiem Bahlol
  • Yaser Mesbah
Assisted Reproduction Technologies



The aim of this study was to examine the effect of clomiphene citrate [CC] co-administration during the use of exogenous low-dose urinary FSH [uFSH] for induction of ovulation in CC-resistant infertile PCOS women.


In a randomised controlled setting, 174 CC-resistant infertile PCOS women were randomized into two parallel groups; Group I received CC 100 mg/day for 5 days plus uFSH 37.5 IU/day while group II received only uFSH 37.5 IU /day. Subsequent increments of uFSH by 37.5 IU/day were made according to response. Primary outcome was ovulation rate. Secondary outcomes were clinical pregnancy rates, number of follicles, endometrial thickness, and gonadotropins consumption.


Our results have demonstrated that group I compared to group II had significantly higher ovulation rate per intention to treat [ITT] [72.4 % vs. 34.2 %, p < 0.001]. Clinical pregnancy and live birth rates were comparable between the two groups. Group I consumed significantly lower total FSH dose and needed significantly shorter stimulation duration compared to group II.


CC co-administered during low dose HP uFSH versus uFSH for CC-resistant PCOS yields significantly higher ovulation rate and less consumption of FSH.


Clomiphene resistant PCOS Chronic low dose FSH Ovulation induction PCOS Randomized controlled trial 



The authors acknowledge the efforts of Ms Nessma, Mr Salah in endocrinology laboratory for their role in serum sample processing and storage. Also we thank the nursing staff and centre secretary for their efforts in patient cycle filing throughout the trial.

Declaration of interest

The authors report no declarations of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mohamad E. Ghanem
    • 1
    • 2
  • Laila A. Elboghdady
    • 1
    • 2
  • Mohamad Hassan
    • 1
    • 2
  • Adel S. Helal
    • 1
    • 2
  • Ahmed Gibreel
    • 2
    Email author
  • Maha Houssen
    • 3
  • Mohamed E. Shaker
    • 4
  • Ibrahiem Bahlol
    • 1
    • 2
  • Yaser Mesbah
    • 2
  1. 1.Mansoura Integrated Fertility CenterMansouraEgypt
  2. 2.Department of Obestetrics & Gynecology, Mansoura Faculty of MedicineMansouraEgypt
  3. 3.Department of Biochemistry, Faculty of PharmacyDamanhur UniversityDamanhurEgypt
  4. 4.Department of Pharmacology & Toxicology, Faculty of PharmacyMansoura UniversityMansouraEgypt

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