Evaluation of oral ovulation induction medications: a retrospective pilot study

Supervisor

Dr. Rowa’ Al-Ramahi 

Abstract

Objectives:

The aims of this study are to compare different oral treatment regimens for ovulation induction in Palestine and predict the most effective one.

In this study we hope that patients can receive the most effective medication by less effort, cost, adverse effects and embarrassment.

Method:

The study was a retrospective(pilot) study that was conducted in a private clinic in Ramallah. The data collection form was completed by reviewing patients’ medical records; woman's age, medical conditions, reason for infertility (diagnosis), duration of infertility, medications used, number of cycles, ovarian drilling, response, Hysterosalpingography, results (pregnancy or miscarriage, twins, congenital abnormalities were included. Descriptive statistics were carried out for all variables.

Result:

During the study, a total of 23 medical records were reviewed. The average age (±Standard Deviation) of patients was27 ± 3.3 years. The average duration of infertility was 2.6 ± 2.8 years. The majority of patients have not been pregnant before. All patients had normal HSG. According to medical records, 61% of patients (14) had Polycystic ovary syndrome, 31% of patients (7) had unexplained causes, while primary or secondary infertility had the same percentage (4% of each).Letrozole was used by 23 patients (19 of them used it at first, while the rest of them used clomiphene before), it stimulated 2 follicles for all cases used it. The mean of endometrium thickness was 10.9mm ±3.3. Nine of them had pregnancy(6 of them from the first cycle but (one of them had miscarriage)while 3 became pregnant from the second (one had a twins she used clomiphene before it). Clomiphene was used by 4 patients, it stimulated 3 follicles, none of them had pregnancy. Tamoxifen was used by one patient for 2 cycles, it stimulated 2 follicles, without pregnancy. Out of the 9 cases who had pregnancy, 2 of them undergone (ovarian drilling).There were no cases of congenital abnormalities

Conclusion:

The most common cause of female infertility is PCOS and letrozole shows the best results therefore, it is the ideal oral ovulation induction medication. Otherwise, clomiphene and tamoxifen gave the same result of unresponsiveness in this pilot study. Further studies with larger number of women are recommended.