The Effect of Normalization of FSH/LH Ratio on the Response to Induction of Ovulation and Pregnancy Rate in Polycystic Ovary Syndrome Patients

Objectives: To determine the role of normalization of FSH/LH ratio on the response to induction of ovulation and pregnancy rate in patients with polycystic ovarian disease.Materials and Methods: This is a randomized controlled trial including 126 infertile women with PCOS attending to infertility clinic, Kasr Al-Ainy Maternity Hospital, Faculty of Medicine, Cairo University, from December 2021 until May 2022. Patients were divided into 2 equal groups:- Group A (63 women): received OCPs for 3 successive cycles and after withdrawal bleeding of last cycle received clomiphene citrate 100 mg tablet orally started on 2nd day to 6th day of the cycle for five consecutive days for another 3 cycles.- Group B (63 women): didn't receive pre-treatment OCPs.Results: The rate of normalization of FSH/LH ratio after COC pills was higher in group A 51/63 (81.0%). Ovulation rate, endometrial thickness at the day of HCG injection and clinical pregnancy rate after induction of ovulation were statistically significant higher in group A compared with group B. Also, total doses of gonadotropin used and percent of cases needed gonadotropin using for induction of ovulation were statistically significant lower in group A compared with group B.Conclusion: In infertile PCOS patients, normalization of FSH/LH ratio in by using of a short pretreatment course of COCs could be used as it was proved to enhance ovulation rate, endometrial thickness at the day of HCG injection and clinical pregnancy rate. Also, it decreases need for using and total doses of gonadotropin and its side effects.