PCOS, Clomid and Infertility

PCOS, Clomid and Infertility

Here’s breaking news….that we have know for about 50 years.

Clomid (clomiphene citrate) (CC) significantly improved ovulation and pregnancy outcomes in women with polycystic ovarian syndrome (PCOS), according to data from 72 women. The part we did not know is how it works. Now there is evidence that Clomid improved markers of PCOS. Nitric oxide (NO), interleukin-10 (IL-10), and matrix metalloproteinase–9 (MMP-9) “are known to be involved in the pathogenesis as well as the complications of PCOS,” wrote Angel Mercy Sylus, MD, of the Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India, and colleagues.

In a study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, the researchers enrolled 72 women with PCOS. The women received 50 mg of oral clomiphene citrate daily on days 3-7 of their cycles to induce ovulation. Levels of NO, IL-10, and MMP-9 were measured at baseline and after 3 weeks. The average age of the women was 25 years, and the average body mass index was 26.4 kg/m2.

After the participants took clomiphene citrate, their levels of NO and IL-10 were significantly higher, compared with baseline, and MMP-9 levels were significantly lower, compared with baseline.

The ovulation rate in the study population was 52.8%, and the clinical pregnancy rate was 19.4%. Levels of MMP-9 were significantly reduced in the ovulatory group, compared with the nonovulatory group, the researchers noted. “Although the mechanism through which clomiphene citrate reduces MMP-9 and increases IL-10 is not clear, the findings indicate that CC therapy improves ovulation by reducing inflammation and reducing MMP-9 levels,” they wrote.

The results have suggested that clomiphene citrate can help promote ovulation and pregnancy for infertile women with PCOS, and further studies are needed to assess the mechanism of action and the effect of higher doses on NO, IL-10, and MPP-9, the researchers wrote.

So after 50 years there is still much we do not know about PCOS but the physicians at RPMG are experts in the clinical management of infertility in patients with PCOS.