{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:06:43Z","timestamp":1775707603550,"version":"3.50.1"},"reference-count":70,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Polycystic ovarian syndrome (PCOS) is a widespread endocrine disorder affecting 5\u201318% of females in their childbearing age. The aim of this study is to assess the efficacy of combining a low dosage of human chorionic gonadotropin (HCG) along with clomiphene citrate (CC) for stimulating ovulation in infertile women diagnosed with CC-resistant PCOS. Materials and Methods: A randomized controlled trial was carried out on 300 infertile CC-resistant PCOS women. All participants were assigned to two groups: the CC-HCG group and the CC-Placebo group. Subjects in the CC-HCG group were given CC (150 mg\/day for 5 days starting on the 2nd day of the cycle) and HCG (200 IU\/day SC starting on the 7th day of the cycle). Subjects in the CC-Placebo group were given CC and a placebo. The number of ovarian follicles &gt; 18 mm, cycle cancellation rate, endometrial thickness, ovulation rate, clinical pregnancy rate, and occurrence of early ovarian hyper-stimulation syndrome were all outcome variables in the primary research. Results: Data from 138 individuals in the CC-HCG group and 131 participants in the CC-Placebo group were subjected to final analysis. In comparison to the CC-Placebo group, the cycle cancellation rate in the CC-HCG group was considerably lower. The CC-HCG group exhibited a substantial increase in ovarian follicles reaching &gt; 18 mm, endometrial thickness, and ovulation rate. The clinical pregnancy rate was higher in the CC-HCG group (7.2% vs. 2.3%; CC-HCG vs. CC-Placebo). Upon adjusting for BMI and age, the findings of our study revealed that individuals in the CC-HCG group who had serum prolactin levels below 20 (ng\/mL), secondary infertility, infertility duration less than 4 years, baseline LH\/FSH ratios below 1.5, and serum AMH levels more than 4 (ng\/mL) had a higher likelihood of achieving pregnancy. In the CC-Placebo group, there was a greater prediction of clinical pregnancy for those with serum AMH (&lt;4), primary infertility, serum prolactin \u2264 20 (ng\/mL), baseline LH\/FSH &lt; 1.5, and infertility duration &lt; 4 years. Conclusions: The use of a small dose of HCG along with CC appeared to be an effective treatment in reducing cycle cancelation, improving the clinical pregnancy rate and ovulation rate in CC-resistant PCOS patients. The trial was registered with Clinical Trials.gov, identifier NCT02436226<\/jats:p>","DOI":"10.3390\/medicina60081300","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T05:19:38Z","timestamp":1723439978000},"page":"1300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Competence of Combined Low Dose of Human Chorionic Gonadotropin (HCG) and Clomiphene Citrate (CC) Versus Continued CC during Ovulation Induction in Women with CC-Resistant Polycystic Ovarian Syndrome: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"60","author":[{"given":"Mahmoud","family":"Thabet","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Sayed","family":"Abdelhafez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maged Ragheb","family":"Elshamy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim A.","family":"Albahlol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"},{"name":"Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emad","family":"Fayala","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Wageeh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abdelhamid","family":"El-Zayadi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagwan Ahmed","family":"Bahgat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shereen M.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alhussein Ahmed","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud Mohamed","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"El-Menayyer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-1743","authenticated-orcid":false,"given":"Mohamed","family":"El-Sherbiny","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia"},{"name":"Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5262-6134","authenticated-orcid":false,"given":"Dalia Mahmoud Abdelmonem","family":"Elsherbini","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, P.O. Box 2014, Sakaka 72388, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5729-9088","authenticated-orcid":false,"given":"Rayan G.","family":"Albarakati","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Baker A.","family":"Alshaikh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-6933","authenticated-orcid":false,"given":"Fawaz E.","family":"Edris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine, Umm AlQura University, Makkah 24382, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0892-8618","authenticated-orcid":false,"given":"Nayla Jamal","family":"Bushaqer","sequence":"additional","affiliation":[{"name":"Bahrain Defence Force (BDF) Hospital, Riffa P.O. Box 28743, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youstina Georges Makarious","family":"Salama","sequence":"additional","affiliation":[{"name":"Bahrain Defence Force (BDF) Hospital, Riffa P.O. Box 28743, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud Mohamed","family":"Abdel-razik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"ref_1","first-page":"1980","article-title":"Prokineticin 1-Is it a reliable biomarker in polycystic ovarian syndrome?","volume":"27","author":"Ulu","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. 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