الفهرس 
POLYCYSTIC OVARY SYNDROMEOnly 14 pages are availabe for public view
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Abstract
Despite the progress in treatment of infertility by using
Invitro fertilization and ICSI, remains the induction of
ovulation the cornerstone and the first step taken for infertility
treatment. Clomid is still the first choice for induction of
ovulation in patients with PCOS with associated infertility.
Many studies have been performed to know the efficacy of
additive therapy to clomid for induction of ovulation; however,
the use of steroids showed significant improvement in
induction of ovulation when added to Clomid; there were some
side effects to the use of steroids in the form of Dexamethasone
including adrenal gland suppression and other known side
effects of steroids.
This study aimed at assessing whether the use of
prednisolone in addition to Clomid for induction of ovulation in
PCOS patients with associated infertility improves ovulation.
Prednisolone has a shorter pharmacologic duration and about
one fifth the potency of Dexamethasone. Prednisolone 10 mg
daily dose administered during the cycle and continued until
confirmation of pregnancy suppresses adrenal androgens with
minimal effects on adrenal corticosteroid reserve. This is
because the desired effect is reduction of adrenal androgens (and potential positive GnRH effects) but not complete adrenal
suppression.
The study included 60 patients with PCOS and
associated infertility recruited at the outpatient clinic of Ain
Shams university maternity hospital from May 2016 to July
2017. The study population was subjected to full history taking,
physical examination, and infertility work up. Then they
received Clomid in addition to either prednisone or placebo
(folic acid) ,and they were followed up by ultrasound for at
least one mature follicle then HCG was given to trigger
ovulation and timed intercourse was advised.
Two days after giving HCG, the patients were assessed
for signs of ovulation (disappearance of pre-ovulatory follicle,
fluid in the cul-de-sac and or corpus luteum formation).
Clinical pregnancy was diagnosed by positive β HCG titer in
blood 2 weeks after ovulation. DHEAS level was measured.
The following are the results of the study. Firstly, no
statistically significant difference noted between both groups
regarding age, weight, height and BMI. Secondly, there is a
highly significant statistical difference between both groups
regarding the ovulation rate as the p value is < 0.001. Thirdly,
there is a statistically significant difference between both
groups regarding day 21 serum progesterone. Fourthly, there is improvement in pregnancy rate in group B compared to that of
group A but with no statistically significant difference between
group A and group B regarding pregnancy rate. Fifthly, there is
a highly statistically significant difference between both groups
regarding the endometrial thickness. Sixthly, there is a highly
statistically significant difference between both groups as
regards the number of follicles > 18mm. Finally, there is a
highly statistically significant difference between both groups
regarding serum level of DHEAs.