Research Article Volume 17 Issue 5- January 2020 DOI: 10.19080/JGWH.2020.17.555972 J Gynecol Women’s Health Copyright © All rights are reserved by Ahmed Mohammed Nofal J Gynecol Women’s Health 17(5): JGWH.MS.ID.555972 (2020) 001 Journal of Gynecology and Women’s Health ISSN 2474-7602 Levothyroxine with Clomiphene Citrate for Ovulation Induction in Patients with Polycystic Ovary Syndrome and Subclinical Hypothyroidism Dalia Ibrahim and Ahmed Nofal* Department of Obstetrics and Gynecology, Menoufia University, Egypt Submission: December 14, 2019; Published: January 03, 2020 *Corresponding author: Ahmed Mohammed Nofal, Department of Obstetrics and Gynecology, Menoufia University, Egypt Introduction Polycystic ovary syndrome (PCOS), affecting about 5 to 10% of women, is characterized by hyperandrogenism, menstrual disturbance, obesity, anovulation, infertility, Insulin Resistance, hyperglycemia, weight gain, and metabolic syndrome (MBS) as hypothyroidism [1]. Hypothyroid disturbances and elevated TSH levels are common findings in PCOS. Nanda et, al. [2] 2014 study revealed the prevalence of hypothyroidism in PCOS was 13.26%. Out of that 57.69% had subclinical hypothyroidism and 42.30 % had overt hypothyroidism Therefore, women with diagnosed PCOS should be screened for thyroid dysfunction. Hypothyroidism causes altered follicle stimulating hor- mone (FSH)/luteinizing hormone (LH) ratio and raised dehydroepiandrosterone (DHEA-S) levels. As excess thyroid stim- ulating hormone (TSH) causes stimulation of FSH receptor [3]. The National Academy of Clinical Biochemistry suggested serum TSH (0.4– 2.5) mIU/L as the normal range, according to United States Preventive Services Task Force (USPSTF) Guidelines de- fined subclinical hypothyroidism SCH as high serum TSH (2.5-10 mIU/L) with a normal FT4 concentration [4]. Subclinical hypothyroidism is found between 3–8% of women of reproductive age, has few signs or symptoms of thyroid dysfunction and often remains untreated. Most of the times hypothyroidism is subclinical and diagnosed first time during evaluation of PCOS. In contrast to overt hypothyroidism, where Abstract Introduction: Polycystic ovary syndrome (PCOS), affecting about 5 to 10% of women [1] Hypothyroid disturbances and elevated TSH levels are common findings in PCOS [2]. Objectives: To study the effect of Eltroxin on ovulatory function in patients with PCO and Subclinical Hypothyroidism (SCH). Methods: This comparative observational study was conducted on 204 patients with PCO and subclinical hypothyroidism who were subdivided into 2 groups. Control group (1):102 patients who received placebo and Clomiphene Citrate (cc) for 3 successive cycles. Study group (2):102 patients who received Eltroxin and (CC) for 3 successive cycles. Patients were followed up for 3 months for ovulation and pregnancy Result: There was no significant difference between cases and controls regarding age, parity, BMI. There was no significant difference between both groups regarding ovarian function represented in LH, FSH, TSH, progesterone before treatment. There was significant difference between both groups regarding ovarian function represented in LH, FSH, TSH, progesterone after treatment There was significant difference between both groups regarding ovulation and pregnancy rates. Conclusion: Eltroxin has beneficial effects on ovulation and pregnancy in patients with subclinical hypothyroidism and PCO Keywords: Eltroxin; Polycystic ovary; Subclinical hypothyroidism Abbreviatations: SCH: Subclinical Hypothyroidism; CC: Clomiphene Citrate; PCOS: Polycystic Ovary Syndrome; MBS: Metabolic Syndrome; FSH: Follicle Stimulating Hormone; LH: Luteinizing Hormone; DHEA-S: Dehydroepiandrosterone; TSH: Thyroid Stimulating Hormone; USPSTF: United States Preventive Services Task Force