What is the
difference between CC Resistance & CC failure:- By CC failure we mean that there is documented ovulation
as evidenced 1) by serial follicular monitoring, or 2) home testing by LH kit
or 3) by estimating day 23 serum
progesterone. And rarely Cervical mucus tests
By contrast CC resistance means there is no
ovulation inspite of timely ingestion of
CC/Letrozole The common causes of CC
resistance are difficult to establish but mostly growth factor related or
genetic . Subtle endocrine disorders or environmental pollutants or endocrine
disruptors may affect the growth of follicles or timely rupture in response to harmonized release of FSH &
LH .
By CC failure, therefore we mean the choice of the drug to induce ovulation was appropite but due to some other factor/ factors(possibly extra ovarian ) conception didn’t occur in that cycle.. Such examples are are 1) Tubal block & tubal diseases 2) Pelvic adhesive disease with altered tubo peritoneal relations 3) Minimal endometriosis, 4) genital Koch’s hitherto undiagnosed and untreated. 5) Abnormal sperm morphology. However , the uncommon causes of CC failure are 6) failure to comply with of timed intercourse as advised like Erectile disorders/ absence of husband due to unavoidable circumstances 7) Defective oogenesis –difficult to diag. This Defective oogenesis ( Inability to acquire competency of get fertilization) occurs in variety of causes but notably IGF disorders, Insulin resistance, Poor endometrial receptivity, Synechiae, polyps, cong abnormalities of uterus, & due possibly abnormal ovarian androgen biosynthesis 8) PRL, disorder.
By CC failure, therefore we mean the choice of the drug to induce ovulation was appropite but due to some other factor/ factors(possibly extra ovarian ) conception didn’t occur in that cycle.. Such examples are are 1) Tubal block & tubal diseases 2) Pelvic adhesive disease with altered tubo peritoneal relations 3) Minimal endometriosis, 4) genital Koch’s hitherto undiagnosed and untreated. 5) Abnormal sperm morphology. However , the uncommon causes of CC failure are 6) failure to comply with of timed intercourse as advised like Erectile disorders/ absence of husband due to unavoidable circumstances 7) Defective oogenesis –difficult to diag. This Defective oogenesis ( Inability to acquire competency of get fertilization) occurs in variety of causes but notably IGF disorders, Insulin resistance, Poor endometrial receptivity, Synechiae, polyps, cong abnormalities of uterus, & due possibly abnormal ovarian androgen biosynthesis 8) PRL, disorder.
Take home
meassage :- Causes of CC failure/ resistance:-has many causes which have to be assessed before embarking
on another Ovulogen oral/ parental. Examples
of such tests are AFC, AMH, PRL, Metabolic disorders, high day 9 LH, PCOS of
several phenotypes , dose of cc employed, . In case of CC failure it invites
possibility of host of anatomical diseases in the form of minimal
endometriosis, Tubo-peritoneal causes, uterine factors, BMI, Kochs, and coital
factor too. as mentioned earlier .
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