Mohammad Ebrahim Parsanezhad
Shiraz University of Medical Sciences, Iran
Title: Management of Clomiphene citrate resistant women with PCOD
Biography
Biography: Mohammad Ebrahim Parsanezhad
Abstract
Polycystic Ovary Syndrome (PCOS) is a heterogeneous disorder in which chronic anovulation is a common feature, despite the presence of multiple microstructures in the ovaries. A growing body of evidence has suggested that serum hyperinsulinemia and as the result hyperandrogenemia contributes to the excess ovarian androgen secretion observed in women with PCOS. Still the standard therapy for anovulatory women with PCOS is administration of Clomiphene Citrate (CC). However, significant proportions of women with PCOS fail to ovulate with the use of standard dosage of CC and are called CC-resistant PCOS. Treatment options including extended clomiphene protocol, clomiphene and dexamethasone combined therapy, insulin-sensitizing agents and/or aromatize inhibitors, as adjuvants to clomiphene citrate and gonadotropins and finally surgical management of PCOD has changed the treatment strategy. Although both standard and novel treatments were addressed in the present review, special attention was paid to the evidence in support of the introduction of glucocorticoids and aromatizes inhibitors as well as surgical management of anovulatory women with CC-resistant PCOS.