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113 recommended as the first-line therapy in these patients. Indeed, clomiphene citrate induces ovulation in about 70%85% of patients although only 40% 50% conceive 195 ; . While a large range of daily doses has been studied, it must be emphasized that an exuberant response may be observed with 50 mg in some patients and, in the USA, the maximal dose approved by the FDA is 100 mg day for five days. The use of clomiphene citrate is currently recommended for only six months because of the putative increased risk of ovarian cancer. Gonadotrophin therapy is indicated for women with anovulatory PCOS who have been treated with clomiphene if they have either failed to ovulate or have a response to clomiphene that is likely to reduce their chance of conception for example, negative postcoital tests ; . To prevent the risks of overstimulation and multiple pregnancy, traditional protocols have been replaced by either low-dose step-up, step-down regimens or by a sequential step-up, step-down protocol. Several studies have shown that these regimens are effective and safe by reducing the number of leading and medium-sized follicles 196198 ; . The risks of multiple pregnancy and OHSS are further reduced if ovulation is triggered with a single injection of hCG and in the absence of more than two follicles larger than 16 mm or more than four follicles larger than 14 mm. In overstimulated cycles, hCG is withheld and the patient advised to refrain from unprotected sexual intercourse. Many published series support the notion that carefully conducted ovulation induction therapy results in a good cumulative conception rate in women with PCOS 199 ; . Different gonadotrophin preparations have been used to induce ovulation in PCOS anovulatory women. Two meta-analyses were carried out on the use of FSH versus hMG treatment. The first concluded that FSH is associated with a reduction of moderate-to-severe OHSS 62 ; . The other 60 ; showed that treatment with FSH results in a 50% higher pregnancy rate in IVF cycles. In spite of the well-known drawbacks of metaanalyses, it may be concluded that FSH is more suitable in PCOS patients to reduce the risk of OHSS, which is still a major concern with this therapy. As hypersecretion of LH is classical endocrine feature of PCOS and may result in reducing the conception rate 200 ; , particular attention has been paid to the possible advantages of adding GnRH-a prior to ovarian stimulation. However, prospective randomized studies have indicated that GnRH-a provide no benefit over gonadotrophin alone and do.
TRADE NAME MEDICAL CONDITION DANGEROUS TREATMENT SUBSTANCE Remicaine Injection Arrhythmia Local Anaesthetic LOCAL ANAESTHETIC Remicard Injection Arrhythmia's LOCAL ANAESTHETIC Renezide Tablets Diuretic DIURETIC Repasma Capsules Asthma Unknown Repotin Injection Bone Marrow Stim EPO Respinol Compound Linctus Coughs Pseudo-Ephedrine Reuibloc injection Local Anaesthetic NO Revaton Syrup Tonic Fencamfamine Rheomacrodex IV Infusion Plasma Expander Plasma Expander Rhinofed Tablets Nasal Congestion EPHED Rinex Diffucaps, Syrup & Paed Syrup Allergy Phenyl-Propanalolamine Ritalin Tablets Stimulant Methyl Phenydate Rolab-Furosemide Tablets Diuretic DIURETIC Rolab-Indapamide Tablets Hypertension Diuretic DIURETIC Rolab-Spironolactone Tablets Diuretic DIURETIC Rondec Syrup Coughs + Colds Unknown Sabax Dopamine Inf Concentrate Stimulant Dobutamine Sabax Furosemide Injection Diuretic DIURETIC Saizen Injection Growth Hormone Somatrodin Salbulin Autohaler Asthma Inhaled Salbutamol Secadrex Tablets Hypertension DIURETIC Sectral Capsules & Injection Angina ARR Hypertension B BETA BLOCKER Sedapain Tablets Pain & Fever CAFFEINE Serevent Disk & Diskhaler, Accuhaler, Inhaler Asthma Inhaled Salmeterol Serophene Tablets Ovulatory Stimulant Clomihpene Servatin Tablets Hypertension DIURETIC Silomat Linctus DA Coughs Clobutinol Occiprenaline Simplene Ophthalmic Solution Ophthalmology Unknown Sinemet Tablets & CR Tablets Parkinsons Stimulant Sinucon Tablets Sinus & Nasal Congestion Caffeine Sinustop Tablets Sinus & Nasal Congestion Unknown Sinustop with Codein Tablets Sinus & Nasal Congestion Unknown Slendoll Tablets Slimming Products ? Slenz Capsules Slimming Products ? Solu-Cortef Injection Cortisone STEROID Solu-Medrol Injection Cortisone STEROID Sosenol Injection Severe Pain PENTAZOCINE Sotacor Injection & Tablets Angina Hypertension & Arrhyth. ETA BLOCKER Sotahexal Tablets Angina Hypertension BETA BLOCKER Spiractin Tablets Diuretic DIURETIC SRM-Rhotard Tablets Severe Pain MORPHINE Steromien Syrup Cortisone STEROID Sublimaze injection Anaesthetic Agent Fentanyl Sudafex Expectorant Coughs + Colds Pseudo-Ephedrine Sulfenta + Forte injection Anaesthetic Agent Sufenta Nil Superbolin Injection Androgen Anabolic Steroids & Androgens Supertest IM Injection Androgen Anabolic Steroids & Androgens Suprefact Injection & Nasal Spray Chemotherapy Tropic Hormone Buserelin Sustanon 250 Ampoules Anabolic Steroid Anabolic Steroids & Androgens Symtofed Tablets & Syrup Nasal Congestion NO Synacthen Depot Injection Tropic Hormone Tetra Cosactide Synarel Gynae preparation NAFARELIN Tamoplex Tablets Hormone Inhibitor TAMOXIFEN 92 PRES. YES YES YES YES YES NO YES YES NO NO NO YES YES YES YES NO YES YES YES NO YES YES NO NO YES YES NO YES YES NO NO NO YES YES YES YES YES YES YES YES YES NO YES YES YES YES YES NO YES YES YES OTHER.