Endometrial Thickness and Subendometrial Vascularity in Anovulatory Polycystic Ovarian Syndrome Patients Treated by Metformin

Abstract

P COS is the most common endocrine disorder among women between the ages of 18 and 44 (Teede et al., 2010) and is thought to affect approximately 2% to 20% of this age group depending on how it is defined (Pal et al., 2016). It is one of the leading causes of poor fertility (Sirmans et al., 2014). In 2009 the Androgen excess and PCO Syndrome society indicated that PCOS should be defined by the presence of hyperandrogenism (clinical and/or biochemical), ovarian dysfunction (oligo-anovulation and/or polycystic ovaries by ultrasound), and the exclusion of related disorders (Aziz et al., 2009). Besides the reproductive abnormalities, Insulin resistance affects 50%–70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes (Sirmans et al., 2014). A study suggested that insulin resistance is an independent risk factor for early pregnancy loss in all women, (Fedorcsak et al., 2000) and another that hyperinsulinemia is also an independent risk factor for recurrent pregnancy loss in normal women (Craig et al., 2002).