Insulin resistance in clomiphene responders and non-responders with polycystic ovarian disease and therapeutic effects of metformin.

Abstract

OBJECTIVES:

To evaluate the clinical features, endocrine and metabolic profiles in clomiphene (CC) responders and non-responders with polycystic ovarian disease (PCOD), and to examine the effects of metformin (MTF) on the above parameters of CC resistance.

METHODS:

A prospective clinical trial was undertaken at the infertility division of a university teaching hospital. Forty-one CC responders were selected and their hormonal and clinical features were determined. Forty-one CC-resistant PCOD women were also selected and clinical features; metabolic and hormonal profiles before and after treatment with MTF 1500 mg/day for 6-8 weeks were evaluated. Women who failed to conceive were treated by CC while continuing to take MTF.

RESULTS:

CC responders had higher insulin levels while non-responders were hyperinsulinemic. Menstrual irregularities improved in 30%. Mean+/-S.D. area under curve of insulin decreased from 297.58+/-191.33 to 206+/-0.1 mIU/ml per min (P=0.005). Only 39.39% ovulated and 24.24% conceived.

CONCLUSION:

PCOD is associated with insulin resistance (IR) particularly in CC-resistant women. Insulin resistance and androgen levels are significantly higher in obese patients. MTF therapy improved hyperandrogenemia, IR, and pregnancy rate.

• Authors: M E Parsanezhad, S Alborzi, A Zarei, S Dehbashi, G Omrani
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 75 Issue 1 Pg. 43-50 (Oct 2001) ISSN: 0020-7292 [Print] United States
• PMID: 11597618 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Blood Glucose
• Fertility Agents, Female
• Gonadal Steroid Hormones
• Insulin
• Clomiphene
• Metformin

Topics

• Adult
• Analysis of Variance
• Blood Glucose (drug effects)
• Body Mass Index
• Clomiphene (metabolism, therapeutic use)
• Female
• Fertility Agents, Female (metabolism, therapeutic use)
• Gonadal Steroid Hormones (blood)
• Humans
• Infertility, Female (drug therapy, metabolism)
• Insulin (blood)
• Insulin Resistance (physiology)
• Metformin (metabolism, therapeutic use)
• Obesity (metabolism)
• Polycystic Ovary Syndrome (drug therapy, metabolism)
• Prospective Studies
• Regression Analysis