Identification of influential factors on ovarian responsiveness with tamoxifen in type-2 WHO anovulatory patients

Background and Chronic anovulation is a common cause of infertility in women. Most women with chronic anoulation have irregular menstural cycles and normal serum FSH concentration s(WHO-type 2). finding out influential factors on ovarian responsiveness is useful for managing the infertile patients. The objective of this study is to assess the relation of some factors on ovulation in infertile women referring to Royan institute between November 2002 to November 2003. A total of 74 normogonadotropic, oligomenorrhic, undergone ovulation induction using tamoxifen, were studied. The factors studied were pretreatment clinical sings (Hirsutism, BMI) endocrine (FSH, LH, Insulin- testosterone) and sonographic screening characteristics of these patients. Ovarian response and ovulation were monitored by ultrasound scans and measurement of mid-luteal progestron. According to statistical analysis pretreatment Hirsutism- BMI – serum LH consentration, LH/FSH ratio and ovarian volume were identified as the significant parameters for prediction of ovulation with tamoxifen (P≤0.05). There was no statistically significant differences in age, duration of infertility, FBS/Fasting insulin ratio and ovulation between the groups. Ovarian responsiveness to tamoxifen in anovulatory infertile women can be predicted on the basis of some initial screening characteristics. The prediction model in this study may improve the outcome and make the treatment more safe and efficient. These approaches should be further evaluated in prospective comparative trial.