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

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.