THE NUMBER OF FOLLICLES AND OVARIAN VOLUME IN THE ASSESSMENT OF RESPONSE TO CLOMIPHENE CITRATE TREATMENT IN POLYCYSTIC OVARIAN SYNDROME

Objective. To evaluate whether the number of follicles and ovarian vol ume have any significance in evaluating the response to clomiphene cit rate treatment in polycystic ovarian syndrome (PCOS). Design. A prospe ctive study of 70 infertile women, 44 of which were diagnosed with pol ycystic ovarian syndrome. Main outcome measures. Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citr ate(CC). Results. Ovarian volume was significantly greater in cases wi th polycystic ovarian syndrome than controls. However, ovarian volume in the Clomiphene Citrate nonresponders was significantly greater than in Clomiphene Citrate responders in the polycystic ovarian syndrome g roup. The number of small follicles was significantly higher in cases with polycystic ovarian syndrome than controls, and in the Clomiphene Citrate nonresponder group this number was also significantly higher t han in Clomiphene Citrate responders. Endocrine features of patients w ith polycystic ovarian syndrome revealed that Dehydroepiandrostenedion e sulfate, Androstenedione, follicle stimulating and luteninizing horm one do not discriminate between patients who respond to Clomiphene Cit rate and those who do not respond. However, Testosterone and luteinizi ng hormone levels differ significantly in responders and nonresponders . Conclusions. Small multiple follicles (>9) and enlarged ovarian volu me (>6.8 mi) were the most prominent transvaginal ultrasonographic fea tures of ovaries in Clomiphene Citrate nonresponsive patients with pol ycystic ovarian syndrome. Higher levels of Testosterone, luteinizing h ormone and significantly higher number of small follicles were associa ted with lack of Clomiphene Citrate response. These ultrasonographic f eatures and laboratory assays could be clinically useful for distingui shing better the Clomiphene Citrate nonresponders from responders.