Ovulation induction in clomiphene-resistant anovulatory women with normal dehydroepiandrosterone sulfate levels: beneficial effects of the addition of dexamethasone during the follicular phase

Abstract

Objective: To evaluate the effect on ovulation of a 10-day course of dexamethasone (DEX) initiated concurrently with a 5-day course of clomiphene citrate (CC) in CC-resistant patients with normal DHEAS levels.

Design: Retrospective review.

Settings: Patients from the clinical practice of the authors at the Medical College of Georgia, Augusta, Georgia.

Patients: Thirteen oligomenorrheic women with normal DHEAS levels who failed to ovulate on a graduated regimen of CC up to a dose of 150 mg for 5 days.

Interventions: Ten-day course of DEX initiated concurrently with a 5-day course of CC; ovulation and pregnancy outcomes recorded.

Main outcome measure: Pregnancy.

Results: Eleven of 13 women had evidence of ovulation. Five clinical pregnancies were achieved.

Conclusion: These initial data support improvements in follicular development with an overlapping follicular phase regimen of CC and DEX in patients with normal DHEAS levels and a previous poor response.