الفهرس 
POLYCYSTIC OVARIAN SYNDROME (PCOSOnly 14 pages are availabe for public view
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Abstract
Clomiphene citrate (C/C) was the first agent used in experiments for ovulation induction in oligomenorrheaic women. For many years it was and may still be the first therapeutic option managing anovulatory infertility.
Objective:
This work was done to compare the standard traditional protocol of induction of ovulation with CC with the stair step protocol regarding number of follicles, ovulation rate and time.
Patient and method:
100 women with polycystic ovarian syndrome were divided in two groups:
Group 1. (Traditional protocol):
Patients were treated by 50mg/d for 5 days from 2 to day 7 of the cycle. Patients who regained normal regular cycles or get pregnant were considered to have treatment sucess, others continued CC therapy for the next cycle by the same regimen with a dose of 100 mg/d. If not responded, the dose was increased to 150mg/d in the third cycle and increased to 200mg/d in the fourth cycle if not responded. Failure of response to this dose was considered as treatment failure.
Group 2. (Stair step protocol):
Patients were treated with 50 mg clomiphene for 5 days from the second day of the menstrual cycle and vaginal ultrasound was performed at 11-14 When there is no response (no follicle > 10 mm), 100 mg clomiphene is intiated immediately for 5 days, and Ultrasound is repeated 1 week after the first Ultrasound and when there is no response, 150 mg clomiphene is initiated immediately for 5 days and Ultrasound was performed 1 week after the second Ultrasound.
Results:
There were no significant differences in both groups in the clinical criteria of patients regarding age, type of infertility and gravidity of the patients, so the two groups were matched.
There were no significant differences in the ovulation between both groups with the dose of 50mg CC per day but with the doses 100 and 150 the stair step protocol shows significantly higher ovulation rates.
There was significantly shorter ovulation time, increased in numbers of follicles and endometrial thickness in stair step protocol.