- Mahtab Zeinalzadeh
 - - Department of Obstet . and Gynecol , Yahyanejad Hospital, Babol Medical Sciences University, Babol, Iran
- Ashraf Alyasin
- - Department of Obstet . and Gynecol ,Shariati Hospital, Tehran Medical Sciences University, Tehran, Iran
- Marzieh Agha Hossinei
- - Department of Obstet . and Gynecol ,Shariati Hospital, Tehran Medical Sciences University, Tehran, Iran
Received: 4/1/2002 Accepted: 4/1/2002 - Publisher : Avicenna Research Institute |
|
| Related Articles |
|
| Other Format |
|
|
|
Abstract
Infertility with an incidence of about 15% has mainly been one of the community burdens that have even been threatening to the continuity of the family life. One of the most prevalent causes of women infertility is ovarian causes particularly PCOS. Since Metformin may improve quality and increase the number of ova, and likewise increase fertilization rate via reducing the level of insulin, this study was conducted with aim of investigating responses of patients with PCOS in the cycle of ART. This was a randomized clinical trial on 100 infertile patients with PCOS who referred to Shariati Hospital in Tehran during 1999-2000. The subjects were randomly categorized in to 2 groups (A=44 and B=46 women). Ten patients were eliminated from study due to ignoring the treatment plan. Group A received Metformin at a dose of 500 mg t.i.d in addition to induction of ovulation with long protocol. The results were analyzed using t-test and X2 and P<0.05 was considered as significant. results showed that average level of estradiol in group a was 2159±1056pg l and 2842±1050pg l in group b, with a significant difference (p="0.002)." we administered 23±7.6 ampules of hmg for the subject’s in group a and 31.34±8.12 ampules for those in group b (p="0.001)." the difference in number of oocytes was not significant, where as we found a significant difference in the number of germinal vesicle (p="0.047)." there were no significant differences in course of treatment, numbers of oocytes and the number of pregnancy between 2 groups. considering the findings of this study by using metformin, we improve the quality of ova in patients with pcos. this happens due to the effect of metformin through reducing insulin resistance and hyperandrogenism in patients with pcos leading to a prominent drop in estradiol levels in serum that in turn lowers the need for administration of hmg and result in improving oocyte quality< pan>
Keywords:
Metformin, Infertility, Assisted Reproductive Techniques, Polycystic ovary syndrome To cite this article:References
- Speroff L., Glass R.H., Kase N.G. Clinical gynecologic endocrinology and infertility. 6thEdition,Baltimore, Lippincott Willims & Wilkins. 1999; pp 1097- 133.
- Balen A.H., Conway G.S., Kaltsas G., et al. PCOS: the spectrum of the disorder in 1741 patients. Hum Repord. 1995; 10: 2107.
- Conway G.S. PCOS: clinical aspects. Baillieres Clin Endocrinol Metab. 1996; 10:263.
- Conway G.S., Jacobs H.S. Clinical implications of hyperinsulinemia in women. Clin Endocrinol. 1993; 39: 623.
- Soule S.G. Neuroendocrinology of PCOS. Baillieres Clin Endocrinol Metab. 1996; 10: 205.
- Balen A.H., Tan S.L., Jacobs H.S. Hypersecration of Luteinising hormone: a significant cause of infertility and miscarriage. Br J Obs Gyn. 1993; 10: 82.
- Kiddy D.S., Hamilton F.D., Seppala M, et al. Diet-induced changes in sex hormone binding globulin and free testosterone in women with normal or PCO correlation with serum insulin and ILGF-1. Clin Endocrinol. 1994; 31: 771.
- Rossing M.A., Daling J.R., Weiss N.S. Ovarian tumors in a cohort of infertile women. N Engl J Med. 1994; 331: 771.
- Seibel M.M. A comprehensive text of infertility. 2th Edition, Boston, Appelton & Lange. 1999; pp 121- 32.
- Velazquez E.M., Mendoza S.G., Wang P., et al. Metformine therapy is associated with a decrease in plasma plasminogen activator inhibitor-1, Lipoproteine (a), and immunoreactive insuline levels in patients with the PCOS. Metabolism. 1997; 46: 54.
- Jacobs H.S. PCOS: etiology and management. Curr Opin Obs Gyn. 1995; 7: 203.
- Vandermolen D.T. Metformine increases the ovulatory rate and pregnancy rate from clomiphene citrate in patients with polycystic ovary syndrome who resistant to clomiphene citrate alone. Fertil Steril. 2001; 75(2): 310- 5.
- Sturrock N.D., Lannon B., Fay T.N. Metformine does not enhance ovulation induction in clomiphene resistant polycystic ovary syndrome in clinical practice. Br J Clin Pharmacol. 2002; 53(5): 469- 73.
- Stadtmauer L.A. Metformine treatment of patients with polycystic ovary syndrome undergoing in vitro fertilization improves outcomes and is associated with modulation of the insuline-like growth factors. Fertil Steril. 2001; 75(3): 505-9.
- Leo V., Carca A.L. Effect of Metformine gonadotropine induced ovulation with polycystic ovary syndrome. Fertil Steril.1999; 72(2): 282-5.
- Uhelan J.G., Vdahos N.F. The ovarian hyperstimulation syndrome. Fertil Steril. 2000; 72(2): 282- 5.
- Fulghesa A.M., Villa P. The impact of insulin secration on the ovarian response to exogenouse gonadotropins in PCOS. Clin Endocrinol Metab. 1997; 82(21): 644- 8.