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The influence of ethnicity on outcomes of ovulation induction with clomiphene citrate in women with PCOS

  • C. Meun
    Correspondence
    Corresponding Author: Cindy Meun, Department of Reproductive Endocrinology and Infertility – Floor Na16, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, the Netherlands
    Affiliations
    Division of Reproductive Endocrinology and Infertility, department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • E. Oostingh
    Affiliations
    Division of Reproductive Endocrinology and Infertility, department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • Y.V. Louwers
    Affiliations
    Division of Reproductive Endocrinology and Infertility, department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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  • J.S.E. Laven
    Affiliations
    Division of Reproductive Endocrinology and Infertility, department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Published:December 26, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.12.017

      Structured abstract

      Research question

      To study the influence of ethnicity on the outcome of ovulation induction with clomiphene citrate (CC) in women with polycystic ovary syndrome (PCOS).

      Design

      A retrospective cohort study. In total, 420 women diagnosed with PCOS from Northern European, Mediterranean, African, South-East Asian and South-American descent, who started ovulation induction treatment with CC, were included. All women were treated with CC according to standardized treatment regime. Minimal effective dose of CC, and the prevalence of clomiphene resistance (CRA) were assessed, and we predicted the chance to become ovulatory.

      Results

      We observed differences in BMI (p=0.002), waist circumference (p=0.036), LH, insulin, and androgen serum levels (all p<0.001) in PCOS women of different ethnicity. Compared to women of Northern European descent, the minimal effective dose of CC in women of other ethnic groups was not different (p>0.2). The prevalence of CRA (p=0.574) was similar in all ethnic groups. We predicted a similar chance of ovulation (p=0.5) in the different ethnic groups.

      Conclusions

      This is the first study aiming to link ethnicity to ovulation induction outcome in PCOS. Although PCOS women of different ethnicity exhibit variation in phenotype expression, it does not appear that there are differences in the prevalence of clomiphene resistant anovulation as well as the minimal effective dose of CC. Furthermore, a prediction model revealed no significant differences in the predicted chance to ovulate. A larger cohort is needed to validate these findings.

      Keywords

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      Biography

      Cindy Meun completed her medical degree in 2013 and is a PhD candidate at Erasmus Medical Center in Rotterdam, the Netherlands. Her research focusses on genetics and cardiovascular disease risk in women with polycystic ovary syndrome.
      Key message
      Although women with PCOS of different ethnicity exhibit variation in the phenotypic expression of PCOS, there seem to be no differences in the prevalence of clomiphene resistant anovulation or the minimal effective dose of clomiphene citrate.