In addition to the above-mentioned parameters, the following characteristics of patients were analyzed: age, cause of infertility (PCOS, anovulation, tubular factor, endometriosis, male infertility factor and idiopathic infertility), BMI, total dose of gonadotropin, protocol use with agonists or antagonists, estradiol values the day of administration of hCG as well as the number of aspirated oocytes.

In China, Recombinant Follitropin Beta is used to treat anovulation (including polycystic ovary disease, PCOD) that cannot be cured by clomiphene citrate.

PCOS falls in the category ofWHOtype II anovulation (norm-gonaddotrophic norm-estrogenic anovulation) and accounts for 85% of anovulatory females (2).

Our study was a Interventional study and was done to induce ovulation among 100 infertile women (Sample size taken as per convenience) having oligo-ovulation or anovulation. It was conducted at the department of Obstetrics & Gynaecology, Calcutta National Medical College & Hospital, Kolkata from February 2017 to August 2018.

2 of these 3 symptoms determine a PCOS diagnosis: irregular periods or no periods as a result of anovulation; abnormal male hormone levels resulting in excess hair, acne, or thinning scalp hair; and/or multiple small ovarian cysts.

The National Institute of Health (NIH) criteria require anovulation (no ovulation) or oligoovulation (rare ovulation) plus clinical or biochemical signs of hyperandrogenism.

Oligo and/or anovulation, excess androgen activity and/or polycystic ovarian morphology on ultrasound.

One third of infertility patients have anovulation of which 80 percent to 90 percent of cases are due to polycystic ovary.

Besides, it is a widespread disease in reproductive age with an incidence of 4%-12% (3), increased androgen levels caused by chronic anovulation, and unopposed estrogens are the major laboratory findings in polycystic ovary syndrome (PCOS) (4).

Several factors have been identified to play a role in the etiopathogenesis of PCOS, among them genetic, androgen excess and insulin metabolism play a key role.6 Women with PCOS have raised LH levels which may be due to increased pulse frequency of hypothalamic gonadotropic hormone (GnRH) or low levels of progesterone resulting from oligo-or anovulation.7,8 Altered FSH to LH ratio stimulate the ovarian theca cells to produce androstenedione.

Hormones that mimic anovulation or menopause, including progestins, oral contraceptives, gonadotropin-releasing hormone (GnRH) analogues or aromatase inhibitors, may be used.

Dr Ahmad added: "PCOS can lead to anovulation. Fifteen per cent of women who have PCOS are infertile because of anovulation, which is lack of ovulation."