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Article
Serum resistin levels, and other hormonal and biochemical parameters in patients with polycystic ovary syndrome (PCOS)

Authors: Haider Al – Shammaa** FIBCOG --- Hedef D. El – Yassin* PhD --- Kamila H. Shamam* MSc
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 2 Pages: 200-203
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Polycystic ovarian syndrome (PCOS) is one of the most common cause of anovulation during reproductive life.Resistin can increase ovarian androgen production by directly stimulating ovarian theca cell or indirectly by augmenting pancreatic – B cell production of insulin.Patients and Methods: Sixty patients with PCOS who were non diabetic and not taking any medicine for the last three months were involved in the study .Thirty normal fertile female serves as control group. Fasting blood samples were aspirated from all individuals from 3rd - 6th day of the menstrual cycle to measure resistin, insulin, glucose, LH, FSH, TT3, TT4, Prolactin , Total Testosterone and lipid profile, by ELISA and routine methods.Results: mean serum resistin concentration was increased in women with PCOS compared with the control group (Mean ±SD) (19.83 ± 6.101 vs 9.36 ± 2.17) ng/ml. Serum resistin concentration correlated positively with BMI, which is divided into two subgroups. The first with BMI < 25 kg/m2 and the second with BMI &#8805;25kg/m2 in both control and patient groups. In BMI < 25kg/m2 serum resistin concentration for the control group was (8.90 ± 1.76) and (14.66 ± 2.09 ) for patients group ,while BMI &#8805; 25 kg/m2 serum resistin concentration for the control group was (10.62 ± 1.76) and (21.55 ± 5.40) ng/ml for patients group. Resistin also correlated positively with Insulin, LH, LH/FSH ratio and total Testosteron in women with PCOS but not in control. Fasting insulin level was higher in PCOS group compared with the control group (Mean ±SD) (27.45 ± 4.47 vs 13.27 ± 3.80) mIU/ml.The Fasting serum glucose was also higher in PCOS group compared with the control group (Mean ±SD) (125.27 ± 28.63 vs 92.63 ± 13.99) mg/dl. Total Testosterone level was elevated in the PCOS group compared with the control group (1.04 ± 0.37 vs 0.52 ± 0.25) ng/ml.Total Testosterone correlated positively with BMI, Resistin, Insulin, LH, and LH/FSH ratio.Conclusion: PCOS women with BMI >25 kg/m² were found to have a marked increase level of Resistin ,Insulin , Glucose ,LH ,and Total Testosterone .and a decrease level in their insulin sensitivity i.e increased insulin resistance.These data indicate that abnormal resistin secretion in obese PCOS women may play a role in causing ovarian hyperandrogenism and hyperinsulinemia. Therefore fasting serum resistin level could be helpful in diagnosing PCOS patient


Article
Estimation of the hepcidin level and some Biochemical parameters in patients of polycystic ovary Syndrome in Kirkuk city
تقدير مستوى الهيبسيدين وعدد من المتغيرات الكيموحيوية في مصل دم المريضات المصابات بمتلازمة المبيض متعدد الاكياس في مدينة كركوك

Authors: Sherin Bahgat Ayed AL- Tikriti1 شيرين بهجت عايد التكريتي1 --- Nazar Ahmed Naji2 نزار احمد ناجي2
Journal: Tikrit Journal of Pure Science مجلة تكريت للعلوم الصرفة ISSN: 18131662 Year: 2019 Volume: 24 Issue: 4 Pages: 34-39
Publisher: Tikrit University جامعة تكريت

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Abstract

Polycystic ovary Syndrome is a common disorder in the endocrine glands, which is characterized by the aggregation of small bags surrounded by theca internal layers bloated follicles .The level of hepcidin and some other biochemical parameters were examined in (60) patients In addition to (30) blood samples of healthy control .The results showed a significant decrease in hepcidin level as well as E2 and progesterone while there was a significant increase in prolactin and testosterone in polycystic ovarian syndrome patients Compared to healthy control. There was no correlation between hepcidin and all other parameters but there was some correlations among parameters used, there was positive correlations between FSH with LH and Testosterone as well as between E2 and Testosterone and between T4 and T3 .

متلازمة المبيض متعدد الاكياس تعد من الاضطرابات الشائعة في الغدد الصم ومن اهم نتائجه عدم الانجاب، اذ يتميز المبيض بتجمع أكياس صغيرة محاطة بطبقات الجريب الداخلي المتضخمة للجريبات المتكيسة.مستوى الهيبسيدين وعدد من المتغيرات الكيموحيوية تضمنت (60 ) مريضة بالإضافة الى (30) عينة الدم للسيطرة. واظهرت نتائج الدراسة الحالية انخفاض معنوي في مستوى هرمون الهيبسيدين وكذلك في المتغيرات (Progesterone ، E2 ( بينما أظهرت متغيرات أخرى ارتفاع في مستوياتها وهي (PRL ، (Testosterone في مرضى متلازمة المبيض متعدد الاكياس مقارنة مع مجموعة السيطرة ، كما لوحظ عدم وجود علاقة ارتباطية بين هرمون الهيبسيدين مع باقي المتغيرات لكن يوجود علاقة ارتباطية ايجابية بين هرمونات FSH مع LH و Testosterone وكذلك بين FSH ، E2 و Testosterone وبين T4 و T3 .


Article
Role of Metformin on Recurrent Miscarriage and Other Pregnancy Complications in Women with Polycystic Ovarian Syndrome

Author: Inaam Faisal Mohammed
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2017 Volume: 7 Issue: 1 Pages: 1-6
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Polycystic ovary syndrome signs and symptoms often begin soon after menarche. In some cases, PCOS develops later during the reproductive years, for instance, in response to substantial weight gain. The PCOS produces symptoms in about 5-10% of women of reproductive age(12-45 years) and it is one of the leading causes of female subfertility.Women with PCOS suffer not only from subfertility, but also from a high rate of early pregnancy loss. About 30-50% of clinically confirmed early pregnancy loss are associated with PCOS.In addition to early pregnancy loss, women with PCOS have increased risk of recurrent miscarriage ,which defined as 3 or more consecutive pregnancy loss before 20 week. Metformin hydrochloride, an insulin sensitizing agent, has been shown to have encouraging effects on several aspect of PCOS like insulin sensitivity, plasma glucose concentration & lipid profile.It is found that using Metformin during pregnancy in women with PCOS may reduce the pregnancy loss and also reduce the risk of gestational diabetes,intrauterine growth retardation(IUGR) & preterm labor.


Article
Evaluation of metformin treatment in patient with polycystic ovary syndrome in Kirkuk city
تقييم علاج الميتفورمين في مرضى متلازمة تكيس المبايض في مدينة كركوك

Authors: Nazhet Abdul qadir --- Ibaa Gassan --- Emil Nasir Azzo --- Iman Sabah --- et al.
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2012 Volume: 16 Issue: 1 Pages: 52-57
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of fertile age, affecting 5-10% of the female population. The aim of the present study is to evaluate the endocrine and metabolic effects of metformin in patients with polycystic ovary syndrome in Kirkuk city.Methods: Eighty female with polycystic ovary syndrome (PCOS), were classified in to two groups, the first group ,who received Clomifene citrate and Metformin hydrochloride included 45 patients and the second group , who received Clomifene citrate only (control group) included 35 patients. All study patients, were diagnosed as polycystic ovary syndrome and they were on treatment at least two months before blood sample collection. Laboratory assessment that obtained included serum, free testosterone, leptin and insulin glucose and lipid profile.Results: No significant differences in median of, serum insulin, insulin resistance or serum leptin between study groups were observed. The median free serum testosterone was significantly lower (23 pg/ml) in those treated with metformin compared to those on ordinary treatment (50 pg/ml). Fasting serum glucose, HDL – cholesterol and total cholesterol were significantly higher in group without metformin (116.2 , 41.3 , 161.8 mg/dL respectively) compaired to group with metformin (101.5, 34.3 , 138.8 mg/dL respectively). The remaining biomarkers (serum LDL-cholesterol, serum VLDL-cholesterol and triglyceride) showed no statistically significant differences between two groups.We conclude that metformin treatment has beneficial effects on serum, free testosterone cholesterol and glucose in obese women with PCOS.


Article
Improving an Ovulation Rate in Women with Polycystic OvarySyndrome by Using Silymarin

Authors: Manal K.Amin --- Yaser A.Atia --- Mohammed A.Taher محمد عباس طاهر
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2010 Volume: 19 Issue: 2 Pages: 11-18
Publisher: Baghdad University جامعة بغداد

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Abstract

Polycystic ovary syndrome(PCOS) is a heterogeneous disorder of uncertain etiology , it is the most common endocrinopathy in women and most common cause of anovulatery infertility ,characterized by chronic anovulation and hyperandrogenemia .The present study was designed to investigate the effect of silymarin which is known to have antioxidant and insulin sensitivity effects on the levels of glucose, insulin ,testosterone ,leutinizing hormone(LH) and progesterone .Ovulation rate and Homeostasis Model Assessment of insulin Resistance (HOMA) ratio were determined .A 3-months of treatment were conducted in 60 PCOS patients in three well-matched groups .The first one (n=20),received silymarin(750mg/day) .The second group received metformin(1500mg/day) while the third group treated by combination of metformin (1500mg/day )and silymarin (750mg/day). All these groups had taken the drugs in divided doses. The results showed significant improvement in all parameters at the end of treatment .The percentage of increment in progesterone levels after completion of treatment were 12.12, 15.9, and 17.51 in groups 1, 2, and 3 respectively and the number of patients ovulated after 3 months of treatment were 4,5, and 10 in groups 1,2, and 3 respectively. However they are more better in group of patients who were treated with combination of silymarin with metformin.In conclusion the addition of silymarin to metformin in treatment of PCOS patients has improving effect on disturbed hormones and ovulation rate.

إن متلازمة المبيض متعدد الأكياس هو اضطراب متغاير لأسباب غير مؤكدة.انه اعتلال هورموني شائع عند النساء وأكثر سبب شائع للعقم المصحوب بعدم الاباضة ويتميز بعدم اباضة مزمن وارتفاع الهورمون الذكري .أن الدراسة الحالية صممت لفحص تأثير السيلمارين وهو الذي يملك خاصية ضد التأكسد و زيادة لتحسس الأنسولين وتقليل المقاومة للأنسولين على مستويات السكر , الأنسولين , الهورمون الذكري, الهورمون اللوتيني والبروجيستسيرون. تم احتساب نسبة الاباظة ودليل مقاومة للأنسولين ( (HOMA أيضا.ثلاثة أشهر من العلاج أعطي ل 60 مريضة بمتلازمة المبيض متعدد الأكياس في ثلاثة مجاميع . المجموعة الأولى مكونة من 20 مريضة عولجن بعقار السيليمارين بجرعة 750 ملغم يوميا والمجموعة الثانية مكونة من 20 مريضة عولجن بعقار المتفورمين وبجرعة 1500 ملغم يوميا بينما المجموعة الثالثة والمكونة من 20 مريضة أيضا عولجن بمزيج الميتفورمين 1500 ملغم يوميا والسيلمارين بجرعة 750 ملغم يوميا .كل هذه المجاميع اخذت العلاج بجرع مجزئة .النتائج أظهرت تحسن المستوى لكل التحاليل بعد نهاية العلاج.ان زيادة نسبة مستويات البروجيستيرون ونسبة الاباضة كانت أفضل في مجموعة المريضات اللواتي عولجن بمزيج السيليمارين والميتفورمين .وفي الاستنتاج إن إضافة السيليمارين للمتفورمين لعلاج المريضات المصابات بمتلازمة المبيض متعدد الأكياس له تأثير حسن على الهومونات المضطربة ونسبة الاباضة.


Article
Rosiglitazone , Metformin or both for Treatment of Polycystic Ovary Syndrome
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Authors: Hillal Y. Al-Khairi --- Waleed R. Sulaiman --- Mohammed A.Taher محمد عباس طاهر
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2008 Volume: 17 Issue: 2 Pages: 80-86
Publisher: Baghdad University جامعة بغداد

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Abstract

This study was designed to show the advantages of using the combination of metformin and rosiglitazone over using each drug alone in treatment of women with polycystic ovary syndrome (PCOS).Forty four women with PCOS were classified into 3 groups , group 1 received rosiglitazone (4mg/day) for 3 months , group ةة received metformin ( 1500 mg/day)for three months and groupةةة received the combination ( rosiglitazone 4mg/day + metformin 1500 mg/day) for the same period of treatment . The blood samples were drawn before treatment and after 3 months of treatment . The fasting serum glucose , insulin , progesterone , testosterone , leutinizing hormone were measured before and after treatment. The reduction of serum insulin , glucose ,homostasis model assessment of insuline resistance ( HOMA-IR) , LH and testosterone levels were greater in the group received the combination of rosiglitazone with metformin than that those taken each one alone. Testosterone levels decreased significantly (P<0.05) from baseline level 1±0.04ng/ml to 0.073±0.32ng/ml after treatment with combination.The rate of ovulation is 29.4%,36.4% , 62.5% in rosiglitazone , metformin and combination of both, respectively.The combination of rosiglitazone with metformin has more beneficial effect on ovulation rate.

هذه الدراسة صممت لعرض الفوائد من استعمال خليط من الميتفورمين والروزيكليتازون على استعمال كل دواء منفردا عند علاج النساء المصابات بمتلازمة المبيض متعدد الاكياس. اربع واربعون امرأة مصابة بمتلازمة المبيض متعدد الاكياس قسمن الى ثلاث مجموعات : المجموعة الاولى تناولت الروزيكليتازون بجرعة 4ملغ يوميا لمدة ثلاثة اشهر و المجموعة الثانية تناولت الميتفورمين بجرعة 1500 ملغ يوميا لمدة ثلاثة اشهر اما المجموعة الثالثة فقد تناولت خليط من الروزيكليتازون بجرعة 4ملغ يوميا والميتفورمين بجرعة 1500 ملغ يوميا لنفس مدة العلاج. نماذج الدم سحبت قبل العلاج وبعد ثلاثة اشهر من العلاج.ان التغيرفي مستويات الكلوكوز , الانسولين, البروجيستسرون , الهورمون اللوتيني والتستوستيرون كان ملحوظا اكثرفي خليط الروزيكليتازون و الميتفورمين مما في حالة اخذ كل دواء منفردا.كما ان مستوى التستوستيرون يقل معنويا عن مستوى الشروع بعد العلاج بالمركب . وكانت نسبة القابلية على انتاج البيض هي29,4 ,36,4 , 62,5 في الروزيكليتازون والميتفورمين وكلتاهما معا على الترتيب ان خليط الروزيكليتازون و الميتفورمين له تأثير نافع على نسبة انتاج البيض.


Article
Prostate Specific Antigen in Polycystic Ovary Syndrome

Authors: Sanaa M. Ali Hadi --- Ansam Al- Bayatti --- Nuhal Jebri
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 3 Pages: 270-273
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism, and anovulatory infertility; it affects 5-10 % of females at their reproductive age. Prostate specific antigen is a glycoprotein that is secreted from the prostate in males and from paraurethral glands and breast in female.OBJECTIVE:To evaluated the total and free prostate specific antigen levels in female with PCOS, and find out its relation with FSH, LH, Prolactin and testosterone (F,T).METHODS:Eight patients with PCOS diagnosed based on three criteria* High LH: FSH ratio; LH luteinizing hormone to FSH follicle stimulating hormone is 2:1 or more particularly in the early phase of menstrual cycle (3-6) day.* Ultrasound reveals polycystic ovaries* Biomedical hyperandrogenism. ; Elevated androgens particularly free testosterone.Forty normal fertile females served as a control group in this study .Blood samples were taken from all individuals from 3-6 day of menstrual cycle to measure total and free prostate specific antigen, total and free testosterone ( by enzyme linked immunosorbent assay) and FSH,LH, Prolactin (by Immunoradiometric assay).RESULTS:Patients with PCOS and controls differed significantly in all parameters studied, except FSH (P >0.05).LH and LH: FSH ratio were significantly elevated in PCOS group compared to normal control group (11.9±5.4 vs. 7.0±0.6) and (2.3±1.1 vs. 1.2±0.1) respectively.Total and free testosterone were significantly elevated in patient with PCOS compared to normal control group (50±9.6 vs 24 ±3.4 ) and (8.9 ±1.0 vs 1.9±0.4) respectively .Total and free PSA significantly elevated in patient with PCOS compared to normal control group (1.2±0.4 vs 0.1±0.02) and (0.04±0.01 vs 0.01±0.003) respectively.Positive correlation between T-PSA, F-PSA and T-testo, F –testoCONCLUSION:Total and free serum prostate specific antigen levels are higher in patient with PCOS.Serum PSA measurement might be marker of hyperandrogenism in females suffering from PCOS


Article
Predictors of letrezole success in ovulation induction among women with polycystic ovary syndrome resistant to clomiphene citrate
عوامل التنبأ للأستجابة لعقار ليترزول المستعمل لتحفيز التبويض عند النساء المصابات بتكيس المبيض المقاوم لعقار كلومفين سيتريت

Author: Fadia Jassim Al-Izzi د.فادية جاسم العزي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 3 Pages: 219-222
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Clomiphen citrate is still the traditional therapy used for inducing ovulation in polycystic ovary syndrome. Between 20-25% of patients with this syndrome does not respond to clomiphen citrate and fail to develop follicles of desirable size. Letrozol, an aromatase inhibitor, is increasingly used for induction of ovulation in women in whom clomiphene citrate was unsuccessful.Methods: In a prospective study, during the period from October 2008 to the end of December 2009, in the infertility clinic in Al-Yarmouk Teaching hospital, fifty one infertile women were diagnosed as having polycystic ovary syndrome according to the Rotterdam criteria; all patients had previously received clomiphene citrate and were diagnosed as having resistance to this drug. Those patients were assigned to receive an aromatase inhibitor, letrezole, in a dose of 2.5 mg, increased to 5 mg in subsequent cycles, given orally from the third day of a spontaneous bleeding or progesterone-induced withdrawal bleeding for 5 days. The primary outcome measures were the number of growing and mature follicles and endometrial thickness. Secondary outcome measures were the occurrence of pregnancy and miscarriage.Results: With 51 patients and 122 cycles of letrezole therapy, we had 84 (69.2%) ovulatory cycle and 18 pregnancies (15.4%). This study has showed that the body mass index is significantly different between the two groups and the cut off point for it is equal to or more than 26 (sensitivity 60.71% and specificity 78.26%). The mean cycle day of human chorionic gonadotrophine (h CG) administration was 13.4±1.67.The mean number of mature follicles (more than 18 mm in size) on the day of h CG administration was 1.21(range 1-2) and the mean endometrial thickness on the same day was 10.2±1.31mm.Letrezole was well tolerated with no reported side effectsConclusion: Induction of ovulation with letrezole in clomiphene citrate-resistant polycystic ovary syndrome patients is associated with limited number of mature follicles without adverse effect on endometrial thickness. The rates of ovulation and pregnancy are encouraging. One of notable findings is the association of high body mass index with high response rate to letrezole.Key word: Aromatase inhibitors (letrezole), polycystic ovary syndrome

الملخص:التقديم: يعتبر عقار كلومفين ستريت هو العلاج التقليدي لتحفيز التبويض في النساء اللواتي يعانين من العقم بسبب متلازمة تكيس المبيض،20-25% من النساء لايستجيبن لهذا العقار لذلك برز استعمال مثبطات أنزيم العطرين لتحفيز التبويض عند النساء اللواتي يعانين من العقم بسبب متلازمة تكيس المبيض بعد عدم استجابتهن لعقار كلومفين ستريت.طريقة البحث: دراسة مستقبلية أجريت للنساء العقيمات بسبب متلازمة تكيس المبيض واللواتي لم تظهر عندهن استجابه لعقار كلومفين ستريت وذلك في عيادة العقم في مستشفى اليرموك التعليمي للفترة ما بين تشرين الأول 2008 ولغاية كانون الأول 2009 . احدى وخمسون مريضه يعانين من متلازمة تكيس المبيض ,الجميع استلمن علاج كلومفين ولم تظهر اي استجابة (حالات مقاومة للكلومفين).تم اعطاء هؤلاء المرضى عقار ليتريزول ,احد المثبطات لإنزيم العطرين, وبجرعة 2.5 ملغرام وتصل إلى 5 ملغرام في الدوره العلاجية الثانية او الثالثة وذلك في اليوم الثالث من النزف . نقاط التقويم النهائية الأولية كانت عدد الحويصلات النامية وسمك بطانة الرحم ,بينما كان ظهور الحمل او الاسقاط هما نقاط التقويم النهائية الثانوية.النتائج: مع51 مريض و 122 دورة علاج مع عقار ليتريزول(أحد مثبطات أنزيم العطرين) تم الحصول على 84 (69.2 %) دورة تبويضية وثمانية عشر حمل(15.4 %),لم تسجل فروقات مهمة بين المرضى اللواتي استجبن للعلاج واللواتي لم يستجبن في معظم المتغيرات فيما عدا متغير واحد هو معامل الكتلة الجسدية ,حيث أظهر البحث أن نسبة الاستجابة تزداد كلما أزدادت هذه المعامل,وكانت معامل الكتلة الجسدية ألاكبر من أو تساوي 26 هي نقطة الفارق وبدرجة من الحساسية تبلغ 60.7 % ودرجة من التخصصية تبلغ 78.2 %.الأستنتاج: تحفيز التبويض في مرضى متلازمة تكيس المبيض المعنت لعلاج كلومفين يتضمن عددا محدودا من الحويصلات ولكن بدون أثر سلبي على سمك بطانة الرحم.نسبة الأستجابة وكذلك نسبة الحمل مشجعة.أظهر البحث علاقة ايجابية بين زيادة معامل الكتلة الجسدية ونسبة الاستجابة.


Article
FINASTERIDE (PLUS ORAL CONTRACEPTIVE PILL) VS METFORMIN IN TREATMENT OF POLYCYSTIC OVARY SYNDROME-RELATED INFERTILITY: A PROSPECTIVE RANDOMIZED TRIAL

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Background:Polycystic ovary syndrome (PCOS) is a common endocrinopathy characterized by oligo-ovulation or anovulation, signs of androgen excess, and multiple small ovarian cysts. PCOS is thought to be one of the leading causes of female subfertility.Objective:To evaluate and compare the effects of finasteride vs metformin in treatment of PCOS related infertility.Methods:Seventy seven infertile married women with an age range between 18 and 35 years were studied complaining from infertility due to PCOS. They were divided into group 1 treated with finasteride (5 mg daily concomitantly with an oral contraceptive pill "OCP" continuously for 2 months) and group 2 was treated continuously for 3 months with metformin (500 mg three times daily). Results:The percentage of patients responded to metformin treatment was 35.89%, whereas 26.32% of patients were responded to the treatment with finasteride-OCP combination. There were no significant difference between metformin and finasteride in regard to the mean number of mature follicles (1.21±0.43 vs 1.2±0.42) and endometrial thickness (7.26±1.1 vs 7.80±2.25 mm) respectively. The pregnancy rate per patient was higher in metformin treated group in comparison to finasteride treated group (60% vs 21.42%); however, this difference was insignificant (P > 0.05).Conclusion:Finasteride has a good promising effect in the treatment of infertility due to PCOS, as more patients responded to an oral finasteride-OCP combination in comparison to those responded to an oral metformin monotherapy and the difference in the pregnancy rate of the two groups was not significant.Keywords:Finasteride, Metformin, Polycystic ovary syndrome, Infertility


Article
Extended Clomiphene Citrate (CC) and Prednisone for the Treatment of Clomiphene-Resistant Anovulatory Women with the Polycystic Ovary Syndrome (PCOS)
الاستخدام المطوّل للكلومفين ستريت والبردنيسون في علاج عدم الاباضة المقاوم لاستخدام الكلومفين وحده في المريضات المصابات بمتلازمة تكيس المبيض المتعدد

Author: Lilyan W. Sersam د. ليليان وديع سرسم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2005 Volume: 18 Issue: 2 Pages: 173-176
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractObjective: To evaluate the effectiveness of a regimen of extended clomiphene Citrate (CC) and prednisone for the treatment of clomiphene-resistant polycystic ovary syndrome (PCOS) patients who had failed to ovulate on CC alone.Design: Prospective interventional study.Setting: Department of Obstetrics and Gynaecology/ Al-Yarmouk Teaching Hospital during the period September 2001 through February 2002.Patients & Methods: Twenty-one anovulatory (PCOS) patients who failed to ovulate after clomiphene citrate (CC) treatment administered for 5 days. Treatment consisted of CC, 100 mg, given on cycle days 3 through 9 (extended). Additionally, patients were given prednisone 5 mg orally each night throughout the cycle. Ovulation was confirmed by midluteal serum progesterone levels. Pregnancy was confirmed by serum hCG Levels and 7-week gestation ultrasound.Results: A total of 21 patients completed 53 cycles of treatment with extended CC and prednisone (mean, 2.5 cycles; range 1-6 cycles). Sixteen (76%) of 21 patients became ovulatory and 40 (75%) of treatment cycles resulted in ovulation. Eleven of 21 patients, (52%) conceived with this therapy. In the conception group, one ended in spontaneous abortion.Conclusion: The treatment with extended CC and prednisone is an economic, safe and effective alternative treatment for PCOS patients in whom the classical treatment with CC has failed.Keywords: Clomiphene Citrate, Prednisone, Polycystic Ovary Syndrome (PCOS)

ملخــصهدفت الدراسة الى تقييم فعالية الاستخدام المطوّل لدواء الكلومفين ستريت والبردنيسون لعلاج عدم الاباضة المقاوم لاستخدام الكلومفين وحده في المريضات المصابات بمتلازمة تكيس المبيض المتعدد. أجريت هذه الدراسة في فرع النسائية والتوليد/ كلية الطب/ الجامعة المستنصرية/ بغداد – العراق في الفترة الواقعة بين أيلول 2001 وحتى نهاية شباط 2002.شملت هذه الدراسة المستقبلية على احدى وعشرين مريضة انطبقت عليهن الصفات التشخيصية لمتلازمة تكيس المبيض المتعدد واللواتي فشلن سابقا في حدوث الاباضة بعد استعمال دواء الكلومفين وحده.تم اعطاء دواء الكلومفين ستريت (100 ملغم) يومياً ابتداءً من اليوم الثالث وحتى التاسع للدورة الشهرية، مضافاً اليه اعطيت كل مريضة دواء البردنيسون (5 ملغم) كل ليلة وخلال فترة الدورة الشهرية بأكملها.تم قياس مستوى هرمون البروجسترون في مصل الدم لكل مريضة في منتصف النصف الثاني من الدورة الشهرية كمؤشر لحدوث الاباضة كما تم اثبات حصول الحمل بقياس مستوى هرمون الحمل (أج، سي، جي) في مصل الدم لكل مريضة اضافة الى الفحص بالامواج فوق الصوتية.اظهرت النتائج حدوث الاباضة في 76% من المريضات وفي 75% من الدورات العلاجية وان احدى عشرة مريضة من مجموع 21 مشاركة بالدراسة (52%) أصبحن حوامل باستخدام العلاج المذكور.يستنتج من هذه الدراسة الى ان الاستخدام المطوّل لدواء الكلومفين ستريت والبردنيسون هو علاج اقتصادي، آمن ومن البدائل الفعالة في علاج المريضات المصابات بمتلازمة تكيس المبيض المتعدد واللواتي لم يستجبن للعلاج التقليدي بالكلومفين ستريت وحده

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