Effect of Metformin after Laparoscopic Ovarian Drilling on Ovulation in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome
Ahmed Mohamed Fahim Metwally;
Abstract
Summary
P
olycystic ovary syndrome (PCOS) is one of the most common female endocrinedisorders. PCOS is a complex, heterogeneous disorder of uncertain etiology, but there is strong evidence that it can to a large degree be classified as a genetic disease.
PCOS includes a heterogeneous collection of signs and symptoms with varying degree of mildness and severity in affecting the reproductive, endocrine and metabolic functions.The classic triad of the disorder includes hirsutism, menstrual dysfunction, and obesity.
Medical treatment of PCOS is tailored to the patient's goals. Broadly, these may be considered under four categories: Lowering of insulin levels, Restoration of fertility,treatment of hirsutismor acne and restoration of regular menstruation.
Clomiphene citrate is still the first line treatment in women with PCOS, yet a significant proportion of women do not respond to treatment with clomiphene citrate. In these clomiphene citrate-resistant women, laparoscopic electro-cautery or ovulation induction with gonadotrophins is indicated. The mechanism of action is unknown but is believed to be related to endocrine changes that result from the procedure.
The aim of this study is to study the Effect of Metformin after Laparoscopic Ovarian Drilling on Ovulation in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome.
In order to achieve this objective, 60 women with CC resistant PCOS fulfilling the Rotterdam criteria were recruited from infertility clinic of Ain Shams University Maternity Hospital.Venous blood samples for the assessment of serum progesteronewere withdrawn on day 21 of the menstrual cycle. Bilateral laparoscopic ovarian drilling was carried out postmenstrual in laparoscopy unit at Ain Shams Maternity Hospital. After LOD patients were divided into two groups, one of them received placebo and the other received Metformin 850 mg bid for 3 cycles,Blood samples for serum progesterone were re-collected on day 21 of the next menstrual cycle.
The results showed no significant effect of Metformin after LOD on ovulation rate.
Also, results showed that there is significant effect of Metformin in cases with high body mass indexand that there is a +ve correlation between BMI and the increase in progesterone level in patients who used Metformin after LOD.
P
olycystic ovary syndrome (PCOS) is one of the most common female endocrinedisorders. PCOS is a complex, heterogeneous disorder of uncertain etiology, but there is strong evidence that it can to a large degree be classified as a genetic disease.
PCOS includes a heterogeneous collection of signs and symptoms with varying degree of mildness and severity in affecting the reproductive, endocrine and metabolic functions.The classic triad of the disorder includes hirsutism, menstrual dysfunction, and obesity.
Medical treatment of PCOS is tailored to the patient's goals. Broadly, these may be considered under four categories: Lowering of insulin levels, Restoration of fertility,treatment of hirsutismor acne and restoration of regular menstruation.
Clomiphene citrate is still the first line treatment in women with PCOS, yet a significant proportion of women do not respond to treatment with clomiphene citrate. In these clomiphene citrate-resistant women, laparoscopic electro-cautery or ovulation induction with gonadotrophins is indicated. The mechanism of action is unknown but is believed to be related to endocrine changes that result from the procedure.
The aim of this study is to study the Effect of Metformin after Laparoscopic Ovarian Drilling on Ovulation in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome.
In order to achieve this objective, 60 women with CC resistant PCOS fulfilling the Rotterdam criteria were recruited from infertility clinic of Ain Shams University Maternity Hospital.Venous blood samples for the assessment of serum progesteronewere withdrawn on day 21 of the menstrual cycle. Bilateral laparoscopic ovarian drilling was carried out postmenstrual in laparoscopy unit at Ain Shams Maternity Hospital. After LOD patients were divided into two groups, one of them received placebo and the other received Metformin 850 mg bid for 3 cycles,Blood samples for serum progesterone were re-collected on day 21 of the next menstrual cycle.
The results showed no significant effect of Metformin after LOD on ovulation rate.
Also, results showed that there is significant effect of Metformin in cases with high body mass indexand that there is a +ve correlation between BMI and the increase in progesterone level in patients who used Metformin after LOD.
Other data
| Title | Effect of Metformin after Laparoscopic Ovarian Drilling on Ovulation in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome | Other Titles | تأثيرعقار الميتفورمين بعد تثقيب المبيض بالمنظار على التبويض فى حالات متلازمة تكيس المبايض المقاومة للكلوميفينسترات | Authors | Ahmed Mohamed Fahim Metwally | Issue Date | 2014 |
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