1. Could Cytochrome P450 2D6, 3A4 and 3A5 Polymorphisms Explain the Variability in Clinical Response to Clomiphene Citrate of Anovulatory PCOS Women?
- Author
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Robin C, Hennart B, Broly F, Gruchala P, Robin G, and Catteau-Jonard S
- Subjects
- Adult, Female, Fertility Agents, Female therapeutic use, France, Genetic Association Studies, Humans, Infertility, Female drug therapy, Infertility, Female genetics, Pharmacogenomic Variants genetics, Polymorphism, Single Nucleotide physiology, Pregnancy, Retrospective Studies, Treatment Outcome, Young Adult, Anovulation drug therapy, Anovulation genetics, Clomiphene therapeutic use, Cytochrome P-450 CYP2D6 genetics, Cytochrome P-450 CYP3A genetics, Polycystic Ovary Syndrome drug therapy, Polycystic Ovary Syndrome genetics
- Abstract
Introduction: Cytochrome P450 2D6, 3A4 and 3A5 are involved in the metabolism of many drugs. These enzymes have a genetic polymorphism responsible for different metabolic phenotypes. They play a role in the metabolism of clomiphene citrate (CC), which is used to induce ovulation. Response to CC treatment is variable, and no predictive factors have thus far been identified., Objective: To study a possible link between the cytochrome P450 2D6, 3A4 and 3A5 polymorphisms and clinical response to CC., Study Design: Seventy-seven women with anovulatory Polycystic Ovarian Syndrome (PCOS) treated with CC were included which determined their cytochrome P450 2D6, 3A4 and 3A5 genotypes and used the results to predict ovarian response to this drug. Predicted responses based on the cytochrome genotypes were compared with the observed clinical responses using the calculation of a weighted Kappa coefficient., Main Outcome Measures: Number of dominant follicles assessed by ultrasound at the end of the follicular phase and confirmation of ovulation by blood progesterone assay in the luteal phase., Results: Concordance between the predicted and observed responses for the combination of the three cytochromes was 36.71%, with a negative Kappa coefficient (K = -0.0240), which corresponds to a major disagreement. Similarly, for predictions based on the cytochrome P450 2D6 genotype alone, only 39.24% of predictions were verified (coefficient K = -0.0609)., Conclusion: The genetic polymorphism of cytochromes P450 2D6, 3A4 and 3A5 does not appear to influence clinical response to CC used to induce ovulation in anovulatory PCOS women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Robin, Hennart, Broly, Gruchala, Robin and Catteau-Jonard.)
- Published
- 2021
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