Clomiphene stair-step protocol for ovulation induction in women with polycystic ovarian syndrome

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American Journal of BioMedicine  Volume 2, Issue 7, pages 840-854, July 2014

Basima Al Ghazali


The objective of this study is to evaluate the efficacy of the clomiphene stair-step protocol to induce ovulation in women with polycystic ovarian syndrome (PCOS) compared to traditional protocol. This single center randomized controlled trial was undertaken. A 140-patients who met all of the inclusion criteria were divided into two main groups and induction of ovulation for both protocols was performed. Follow up of follicular maturation is done by transvaginal ultrasound. The time to ovulation with the stair step protocol was 21-28 days as compared with the traditional protocol which was 42-70 days. The dose dependent ovulation rate was 43% at 100 mg with the stair step protocol compared with 25.3% with the traditional regimen and the ovulation rate at 150 mg was 21.6% with the stair step protocol compared with 14.7% with the traditional protocol while the clomiphene citrate resistance rate was higher with the traditional protocol 38.7% as compared to the stair step method which was 20% which are statistically significant. This randomized controlled trial suggests that clomiphene stair step protocol decreases the time to ovulation and may improve ovulation rates in clomiphene-resistant women.

Keywords: Polycystic ovarian syndrome (PCO); Stair-step and traditional protocol; Transvaginal ultrasonography


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