Hormonal parameters and conception rate during five different types of treatment of polycystic ovarian syndrome

Hormonal parameters and conception rate of 66 women with polycystic ovarian syndrome (PCO) were studied in a prospective way. Main therapy was clomiphene citrate (N 25) for 6 cycles. Previous clomiphene failures (N 23) underwent ovarian wedge resection, and they who did not menstruate after wedge resection (N 9) received further clomiphene as above. Patients, who did not want to conceive, were treated with dydrogesterone (N 11) or with an estrogen-progestin combination pill (N 7). Clomiphene citrate and ovarian wedge resection decreased luteal phase FSH and LH levels, increased serum estradiol and resulted in frequent ovulations (clomiphene 80%, wedge resection 45%, wedge resection + clomiphene 67%) and pregnancies (clomiphene 60%, wedge resection 36%, wedge resection + 67%), whereas cyclic progestin and estrogen-progestin treatment lowered elevated serum testosterone concentrations without influencing on FSH or luteinizing hormone (LH) levels. Thus clomiphene citrate seems to be the therapy of choice in infertile PCO patients, whereas progestin or estrogen-progestin lower the elevated testosterone concentrations in serum.