The efficacy of adding Dexamethazone to Clomiphene citrate in the treatment of polycystic ovary syndrome and infertility

The aim of this work was to evaluate the efficacy of adding Dexamethazone (DEX)) to Clomiphene citrate (CC) in polycystic ovary syndrome (PCOS) with normal dehydroepiandrosterone sulphate (DHEAS) in induction of ovulation.

120 infertile women with PCOS were randomly assigned into two groups. Group I: Clomiphene citrate 100 mg/day was given from day 3 to day 7 of the cycle and DEX 1 mg/day from day 3 to day 12 of the cycle. Group II: Same protocol of CC combined with placebo (Folic acid tablets) was given from day 3 to day 12 of the cycle. The main outcome was ovulation. Secondary measures included number of follicles >18 mm, pregnancy rate and ovarian follicular response were monitored by ultrasound.

There were no statistically significant differences between groups as regards age, duration of infertility, BMI, menstrual pattern, serum DHEAS. The mean number of follicles >18 mm were significantly higher in the DEX group than in the placebo group (p=0.059). Similarly, there were significantly higher rates of ovulation and pregnancy in the DEX group. Dexamethazone was very well tolerated as no patients complained of any side effect.

Induction of ovulation by adding DEX to CC in PCOS with normal DHEAS is associated with higher ovulation and pregnancy rates and seems to be an effective, cheap and simple method.