The Ovarian Reserve and Clinical Characteristics of The Polycystic Ovary Syndrome (PCOS) Patient Subgroups After Clomiphene Citrate Challenge Test

Ahn, K H; Yoon, B K; Lee, J H; Choi, D S

Abstract

In this study, we investigated the ovarian reserve and clinical charateristics of the polycystic ovary syndrome patient subgroups after conducting the clomiphene citrate challenge test (CCCT). Transvaginal sonography, clinical charateristics, basal serum testosterone, DHEAS, and LH levels were assessed in 103 infertile patients who visited Samsung Medical Center from August 1996 to August 1997. Based on laboratory findings, 63 patients with sonographic PCO pattern were classified as the following subgroups. Group I: PCO pattern only, Group II: PCO pattern with elevated serum testosterone (>0.4 ng/ml) or DHEAS (>1.47 ug/ml) levels, and Group III: PCO pattern with high basal serum LH (>10 mIU/ml) levels. CCCT was performed in all patients. The results are as follows : 1. Ovarian reserve of PCOS patients assessed by CCCT did not diminish. 2. Compared with the control group , patients with PCO revealed lower ovulation rate (P<0.05) and lower serum level of E2 at 10th day of menstrual cycle (P<0.05). 3. There were significant differences among 3 subgroups that Group I showed lower rate of oligomenorrhea (P<0.05), Goup II had higher proportion of obese patients(BMI>25 kg/m2) than other PCOS subgroups (P<0.05), and Group III patients showed the highest rate of oligomenorrhea and the lowest rate of ovualtion after CCCT (P<0.05). In conclusion, the ovarian reserve of PCOS patients assessed by CCCT does not diminish. But among 3 subgroups of PCOS, there are significant differences in ovulation rate and in clinical characteristics after CCCT which might have come from the reflections of different endocrine environment of the PCOS subgroups. study suggests that the classification of PCOS could be a useful parameter in the individualized management of PCOS patients.