Effect Of Oral Contraceptive Pills Pretreatment On Ovarian Response In Patient with Clomiphene Resistant

Background: Clomiphene citrate (CC) is the first drug and the most available treatment for ovulation induction due to it is low cost, easy to administrate and with low side effect. It can induce ovulation in 75% of women. 27% of anovulatory female with normal FSH level who do not respond to CC considered to be CC resistant. Combined Oral contraceptive pills are used for anovulatory infertile women to improve reproductive outcome.Aim of the study: To evaluate the effectiveness of pretreatment with combined oral contraceptive pills in clomiphene resistant cases regarding ovulation & pregnancy rate.Subjects and methods: A randomized clinical trial was conducted on 32 subfertile women proved to be resistant to clomiphene citrate. They were divided in to two groups: Group A (Study group) included 16 females received continuous OCPs for 42 days and after withdrawal bleeding received clomiphene citrate 150 mg tablet orally started on day 2 to day 6 of menstrual cycle. Group B (control group) included 16 females not received treatment for two spontaneous cycles and then received clomiphene citrate 150 mg tablet orally started on day 2 to day 6 of menstrual cycle. There was highly significant difference between the both groups in all three cycles regarding ovulation rate and pregnancy rate with higher rate in study group than control group.Conclusion: Pretreatment with OPCs pills results in excellent rates of ovulation and pregnancy in patients who were previously clomiphene resistant.