Clomiphene citrate mild stimulation improved follicular development outcomes in PCOS women with high luteinizing hormone and poor ovarian response: A case report

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a main cause of anovulatory infertility in women of reproductive age. About 30% to 50% of patients with PCOS has high serum basal luteinizing hormone (LH) levels, and almost 5% of PCOS women with high LH have poor ovarian response (POR). We reported a case of a PCOS woman with high basal LH levels who canceled due to POR during two consecutive controlled ovarian stimulation treatments, which was considered to be related to the suppression of LH levels during downregulation. Clomiphene citrate (CC) combined with human menopausal urinary gonadotropin (HMG) mild regimen did not affect LH levels and obtained good follicular development, providing a new treatment insight for patients with PCOS combined with POR. Patient concerns: A 28-year-old PCOS woman with high basal LH levels, underwent IVF assisted pregnancy treatment in our hospital, whom canceled due to POR during two traditional controlled ovulation induction program. Follicular development was finally achieved with CC milder protocol. Diagnosis: This patient with the diagnosis of PCOS was undergone IVF assisted pregnancy treatment in our hospital. Interventions: CC protocol supports the development of follicular. Outcomes: CC protocol resulted in better follicular development and high-quality embryos due to the continuous maintenance of an elevated LH levels. Conclusion: PCOS women with poor ovarian response required relatively higher LH to maintain the normal development of follicles.