P–713 The effect of aging and polycystic ovarian syndrome on the maturation and apoptosis of granulosa cells from women undergoing controlled ovarian hyperstimulation with recombinant hFSH

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
K Papageorgiou ◽  
E Mastora ◽  
E Kesikiadou ◽  
A Zisiadi ◽  
A Genopoulou ◽  
...  
Keyword(s):  
Gene Expression ◽  
Granulosa Cells ◽  
Polycystic Ovarian Syndrome ◽  
Oocyte Retrieval ◽  
Serum Levels ◽  
Ongoing Study ◽  
Biological Aging ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome

Abstract Study question What is the effect of biological aging and polycystic ovarian syndrome (PCOS) on steroidogenic and apoptotic pathways of granulosa cells isolated from women undergoing IVF? Summary answer This analysis revealed that aging as well as PCOS influence the response of women to ovarian stimulation, affecting steroidogenesis and apoptosis on granulosa cells. What is known already Infertility and subfertility affect a significant proportion of humans worldwide. Age-related factors in women lead to a decrease in the ovarian oocyte reserve, and PCOS, a pathological condition characterized by anovulation and hyperandrogenism, are the two most common reasons of subfertility. Despite the progress in recent years, the causes are still ill-defined, and there is a strong need for interventions to ensure good quality oocytes in healthy aging, as well as in PCOS women. Gene expression analyses of granulosa cells isolated during oocyte retrieval are highly informative for understanding the communication between oocytes and follicular cells and optimizing IVF outcomes. Study design, size, duration This report is part of an ongoing study starting from June 2020. 42 women undergoing IVF/ICSI at the University Hospital of Ioannina, Greece, volunteered to participate with informed consent. Participants were divided into three groups: 30- to 35-year-old patients with PCOS, 30- to 35-year-old non-PCOS women, and older women aged 38- to 42-year-old. All participants received 150 – 300IU/d recombinant hFSH. Participants/materials, setting, methods: Granulosa cells (GC) were collected from the follicular fluid at the day of oocyte retrieval using the protocol described by Ferrero et al., 2012 with modifications that allow us to isolate nearly pure populations, also from small or very few follicles. GC purity was determined by FACS and immunocytochemistry. Reverse Transcription-quantitative-PCR was employed to correlate the expression of steroidogenesis- and apoptosis-related genes with the clinical characteristics of each participant, including FSH and progesterone/estradiol serum levels. Main results and the role of chance FACS and immucytochemistry analysis using specific markers of granulosa cells, like FSHR, as well as leucocyte and erythrocyte cell markers (CD45 and Glycophorin) confirmed the purity of the isolated granulosa cell populations. No differences were found in hormone serum levels between 30- to 35-year-old PCOS (Group A) and non-PCOS women of the same age (Group B) whereas progesterone and estradiol serum levels were lower in 38- to 42-year-old women (Group C) compared to group B. RT-qPCR analysis of maturation-related genes (ZP3 and AHR) revealed the presence of more immature follicles in Group A compared to the other groups. The granulosa cells from women of group A were characterized by increased expression of genes involved in steroidogenic pathways (such as FSHR, CYP17A1) compared to group B, as well as of the genes for the estradiol and progesterone receptors (ESR1 and PGRMC1, respectively), and by decreased levels of the apoptosis-related genes BAX and BCL-xL. Importantly, the granulosa cells from the women of Group C were characterized by lower mRNA levels of steroidogenesis-related genes, as well as of ESR1, and by increased apoptosis as revealed by the increased ratio of BAX/BCL2 transcripts, compared to Group A. Limitations, reasons for caution The presented results of gene expression analysis are based on preliminary data as the number of participants is small (6 women per group), but they are part of an ongoing study where the number of participants is increasing in order to improve quantification and reproducibility of our results. Wider implications of the findings: Potential differences in signaling pathways that are crucial for the maturation of granulosa cells and follicles during biological aging or in pathological conditions such as PCOS are expected to provide valuable information concerning the response of individual women to gonadotropin stimulation and might help to design more personalized therapeutic strategies. Trial registration number Not applicable

scholarly journals Effect of progressive resisted exercises and aerobic exercises in the management of polycystic ovarian syndrome among young women- A pilot randomized controlled trial

Biomedicine ◽  
2020 ◽  
Vol 39 (4) ◽  
pp. 608-612
Author(s):  
Veena Kirthika S. ◽  
Jibi Paul ◽  
Senthil Selvam P. ◽  
Sathya Priya V.
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Free Testosterone ◽  
Reproductive Age ◽  
Group A ◽  
Young Subjects ◽  
Group B ◽  
Ovarian Syndrome ◽  
Hormonal Levels

Introduction and Aim: Polycystic ovarian syndrome (PCOS) is a heterogenous, multisystem endocrinopathy in women of reproductive age also called as Stein Leventhal syndrome. PCOS is a common female endocrine disorder with prevalence ranging from 2.2% to 26%. Prevalence of PCOS in Indian adolescents is 9.13%. This draws attention to the issue of early diagnosis in adolescent girls. The aim of this study was to determine the effect of progressive resisted exercises (PRE) and aerobic exercises in the management of subjects with PCOS. Materials and Methods: This was an experimental comparative pre and post-test type study. The subjects in the age group of 18-25 years with the diagnosis of PCOS were selected based on Rotterdam criteria and with the BMI ranging between 25-29. Twenty four subjects were recruited and were randomly divided into two groups. group A was treated with PRE +aerobic exercises + diet and group B with aerobic exercises + diet. The duration of the study was 24 weeks and the outcome measures used were BMI, PCOSQ and hormonal levels (SHBG, Free testosterone, HOMA IR, Hs CRP) Results: The result of the study showed that group A treated with PRE + aerobic exercises + diet had significant improvement in BMI at P?0.05 and PCOSQ and specific hormonal levels at P?0.001 when compared to group B. Conclusion: A 24 weeks exercise intervention with a combined PRE +aerobic exercises +diet was superior to aerobic exercises +diet among young subjects with PCOS. Keywords: BMI; quality of life; PRE; PCOSQ; Hormones.

scholarly journals COMPARISON OF OVULATION INDUCTION LETROZOLE AND CLOMIPHENE CITRATE IN SUBFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

2021 ◽  
Vol 71 (5) ◽  
pp. 1844-47
Author(s):  
Amna Shafiq ◽  
Rabiya Akbar ◽  
Uzma Urooj ◽  
Sadaf Zohra ◽  
Shazia Afzal ◽  
...  
Keyword(s):  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Military Hospital ◽  
P Value ◽  
Polycystic Ovaries ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome ◽  
Fertile Women

Objective: To compare the ovulation induction of letrozole and clomiphene citrate in sub-fertile women with polycystic ovarian syndrome. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jun 2018 to Aug 2019. Methodology: A total of 116 married sub-fertile women with polycystic ovarian syndrome, 16-40 years of age were included. Patients with previous surgery related to genital tract, hypothyroidism and chronic renal failure were excluded. Letrozole 5.0mg daily from Day 5-9 of menstruation was prescribed to group A women and clomiphene citrate 100 mg daily from Day 5-9 of menses was given to group B women. Results: In group A and in group B, mean age was 29.78 ± 4.71 years and 29.95 ± 4.22 years respectively. Most of the patients 59 (50.86%) were between 18-30 years of age. Mean duration since marriage was 4.23 ± 1.42 years. Mean body mass index was 29.71 ± 2.65 kg/m2. Frequency of ovulation of clomiphene citrate and letrozole in sub-fertile women with polycystic ovaries was 28 (42.28%) versus 42 (72.41%) respectively (p-value=0.008). Conclusion: This study concluded that ovulation induction of letrozole is better than clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.

scholarly journals COMPARISON OF EFFICACY BETWEEN LETROZOLE AND CLOMIPHENE CITRATE IN FEMALES PRESENTED WITH INFERTILITY DUE TO POLYCYSTIC OVARIES.

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Sumreen Anjum ◽  
Afshan Ambreen ◽  
Munazzah Bashir ◽  
Asiya Nawaz Alvi ◽  
Aasma Hanif ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Local Population ◽  
P Value ◽  
Polycystic Ovaries ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a genetically heterogeneous syndrome in which females often have to confront with the issue of infertility. Medical management of PCOS is aimed at the treatment of anovulation and menstrual irregularity. Letrozole and clomiphene citrate are two successful drugs for management of PCOS but contradiction is present in literature that which drug is more effective. So we conducted this study to find more successful drug to be implemented in future in local population. Objective: To compare the efficacy of oral Letrozole versus Clomiphene Citrate in females diagnosed with infertility due to polycystic ovaries Subjects & Methods: This randomized control trial was conducted at department of Gynaecology & Obstetrics, Fatima Memorial Hospital, Lahore for 6 months (May to November 2020). The non-probability, consecutive Sampling was used. Informed consent and demographic data was noted. Then females were randomly divided in two group by using lottery method. Females in Letrozole group were prescribed 2.5-7.5 mg daily from Day 2-Day 6 of menstruation and females in clomiphene citrate group was prescribed 50-150 mg daily from Day 2-Day 6 of menses. Females were advised to visit after every cycle till 3months. On every visit transvaginal ultrasonography was done to assess presence of follicles and number and size of follicles and endometrial thickness. All the data was entered on SPSS version 20. Results: The mean age of the patients was 26.13±5.07 years in group A and 27.17±5.95 years in group B. After 3rd month, the mean endometrial thickness in group A was 8.45±0.58 mm and in group B was 7.45±0.58 mm, the mean follicle was 23.75±4.253 in group A while 20.38±6.154 in group B. The ovulation occurred in 48 cases in group A and in 29 cases in group B. The efficacy was achieved in 36 cases in group A and 16 cases in group B and the difference in both groups was statistically significant i.e. p-value=0.000. Conclusion: Thus the Letrozole has significantly higher efficacy as compared to Clomiphene citrate. So from the results of our study we recommend letrozole as first line treatment for the management of PCOS. Keywords: Polycystic ovarian syndrome, PCOS, Letrozole, Clomiphene Citrate, Efficacy, Infertility

scholarly journals A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF RAJAPRAVARTAKA CHURNA AND HINGUVACHADI CHURNA IN PCOS

2021 ◽  
Vol 9 (10) ◽  
pp. 2397-2403
Author(s):  
Shabeena. I. Attar ◽  
Shivale. Digamber
Keyword(s):  
Clinical Study ◽  
Polycystic Ovarian Syndrome ◽  
Causative Factors ◽  
Wide Range ◽  
Calorie Diet ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
Disor Ders ◽  
Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is the most common health problem caused by a disproportion of reproduc- tive hormones with the ovarian expression of various metabolic disorders and a wide range of clinical features such as obesity, menstrual abnormalities and hyperandrogenism. In this modern era, the erratic lifestyle, high- calorie diet and deskbound jobs have resultantly expanded the spread of hormonal disparities and menstrual disor- ders have led to an increased prevalence of PCOS up to 20-30 %. There are similar conditions explained in the classics under the context of Pushpaghni jataharini. The treatment should be Kapha-Vata hara, vatanulomana, dipana, pittavardhaka along with avoidance of causative factors. Considering the above facts, Rajapravartaka churna and Hinguvachadi churna were selected for the study. The present study was aimed to bring out the effect of Ayurveda in PCOS, which is safe and non-hormonal. Objectives of the study: 1) A comprehensive study of PCOS and its congruence in Ayurveda. 2) To study the efficacy of Rajapravartaka churna and Hinguvachadi churna in PCOS and to compare its efficacy. Materials and Methods: A randomized comparative clinical study of two groups, consisting of 20 patients in each group. Group A - Rajapravartaka churna orally in the dose of 3gm twice daily along with tila kwata as an anupana 50ml; before food for a period of two consecutive cycles. Group B was given Hinguvachadi churna orally in the dose of 250mg twice daily along with water; before food for a period of two consecutive cycles. Results and Interpretation: The study has shown a statistically signifi- cant difference between each group in its efficacy. Conclusion: Rajapravartaka churna showed better results thanHinguvachadi churna while taking the account of the percentage of each criterion. Keywords: Polycystic ovarian syndrome, Pushpaghni Jataharini, Rajapravartaka Churna, Hinguvachadi Churna.

scholarly journals Comparison of Myoinositol versus Combination of Metformin and Myoinositol in Ovulation Induction in Polycystic Ovarian Syndrome

2021 ◽  
Vol 15 (6) ◽  
pp. 1494-1496
Author(s):  
T. Akhtar ◽  
F. Shaikh ◽  
Basma . ◽  
W. U. N. Ahmed ◽  
S. Lashari ◽  
...  
Keyword(s):  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Transvaginal Ultrasound ◽  
Clinical History ◽  
Insulin Sensitizer ◽  
Group A ◽  
Physical Examinations ◽  
The Difference ◽  
Group B ◽  
Ovarian Syndrome

Objective: To compare the efficacy of insulin sensitizer myoinositol versus a combination of myoinositol plus metformin for ovulation induction in polycystic ovarian syndrome. Study Design: Prospective, randomize control trail. Place & Duration of Study: Department of Obstetrics & Gynaecology, Sheikh Zayed Women Hospital Larkana from 1st January 2017 to 31st December 2017. Methodology: Sixty patients were recruited. The proper clinical history, demographic and physical examinations were recorded. Sixty patient divided in two groups A and B, each group receive 30 patients. Group A received myoinositol 1 gm twice daily plus ovulation (letrozole +gonadotrophin) and Group B received two insulin sensitizer myoinositol and metformin plus ovulation induction protocol(from 2-6 days and 7-9 days. Transvaginal ultrasound performed on day 12 of all patients to see the follicular size. Results: Mean age of participants was 26.4±4.4 years and LH/FSH ratio was >1.5. Oligomenorrhea, infertility, hirsutism, and overweight were the major clinical manifestation of women with PCOs. Twenty nine women with PCOs of group A (metformin plus myoinositol) were increased number of follicles as compared to women of group B (myoinositol alone), the difference was statistically significant (p<0.05). Conclusion: The combination of these two drugs ‘Metformin and Myoinositol’, work synergistically that gives more metabolic and reproductive benefits as compared to single drug work alone. Keywords: Polycystic ovarian syndrome, Ovulation, Metformin, Myoinositol, Insulin sensitivity

scholarly journals PCOS

2018 ◽  
Vol 25 (04) ◽  
pp. 568-572
Author(s):  
Ayesha Tariq ◽  
Muhammad Azeem Mir ◽  
Saba Babar ◽  
Rahat Akhtar
Keyword(s):  
Sample Size ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Obstetrics And Gynecology ◽  
Chi Square ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Ovarian Syndrome ◽  
Trial Setting

Objectives: The objective is to compare the efficacy of Pioglitazone andMetformin for ovulation in patients of polycystic ovarian syndrome. Study Design: Randomizedcontrol trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period:January 2017 to June 2017. Methodology: Total number of 66 patients was recruited for thisstudy. These patients were admitted through or outpatient department. Group A and Group B,33 patients each. In Group-A patients received metformin while in Group B pioglitazone wasadministered. Sample size was calculated using the reference study by Chaudhry I et al (9)using sample size calculator for two proportions (power of study 80% and confidence interval95% where prevalence (P1) was 52.17% and (P2) 75%). In group-A patients, Metformin withdose of 1500 mg per day in three divided doses were given for 6 months. In group B patients,Pioglitazone 15mg was administered for 6 months. At the end of 6 months, all the patients wereevaluated for efficacy. Results: Total no. of 66 patients was included. The mean age and BMIof the patients was 29.35±4.01 years and 29.74±2.75 kg/m2 respectively. The age distributionnoted as 66.7% (n=44) patients between 18-30 years and 33.3% (n=22) between 31-37 years.BMI distribution observed as 45.5% (n=30) patients between 24-29 kg/m2 and 54.5% (n=36)patients between 30-34 kg/m2. These 100% (n=66) patients were divided into 2 groups equally,33 in each, i.e. group A and group B. The mean age and BMI of the patients of group Awas 29.42±4.32 years and 29.87±2.58 kg/m2 respectively, while the mean age and BMI ofthe patients of group B was 29.27±3.75 years and 29.60±2.94 kg/m2 respectively. Ovulationwas noted as 42.4% (n=14) and 45.5% (=15) for groups A and B respectively. No associationwas found between efficacy and ovulation (p=0.849). Efficacy was notes as 69.7% (n=23) and72.7% (n=24) for group A and group B respectively. No difference was found between efficacyand groups i.e. between pioglitazone and metformin for ovulation in patients of polycystic ovarysyndrome (p=0.786). Similarly, no association was found between efficacy with age (p=0.442)and BMI (p=0.728), after applying the chi-square. Conclusion: This study concludes thatPioglitazone is as much effective as metformin for ovulation induction in women with PCOS.

Comparison of Clomiphene Citrate Plus N-Acetyl Cysteine and Clomiphene Citrate Alone for Induction of Ovulation in Polycystic Ovary Syndrome

2021 ◽  
Vol 15 (6) ◽  
pp. 1253-1255
Author(s):  
S. Waseem ◽  
S. Gohar ◽  
M. Afzal ◽  
Z. Wali
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Ovary Syndrome ◽  
Obstetrics And Gynaecology ◽  
Group A ◽  
Acetyl Cysteine ◽  
Group B ◽  
Ovarian Syndrome

Aim: To compare the frequency of ovulation with clomiphene citrate plus N-acetyl cysteine versus clomiphene citrate alone in married females presenting with polycystic ovarian syndrome. Study design: Randomized clinical trial Place and duration of study: Department of Obstetrics and Gynaecology, Unit-3 Jinnah Hospital, Lahore from 1st September 2018 to 28th February 2019. Methodology: A total of 60 patients (30 in each group) were enrolled. In group A, females were prescribed clomiphene citrate 50-mg tablets twice daily with N-acetyl cysteine 1200 mg/day orally for 5 days starting on day 3 of the menstrual cycle and in group B, females were prescribed clomiphene citrate 50-mg tablets twice daily. Results: Patients ranged between 18-35 years of age. Mean age of the patients was 28.5±3.3 and 28.1±3.1 years in group A and B, respectively. Mean duration of marriage in group A was 3.4±0.9 and in group B 3.5±0.9 year. Mean BMI in group-A was 3.4±0.9 while in group-B 3.5±0.9 (kg/m2). Ovulation was observed at 1st month in group A was 12 (40%) and in group B 9 (30%). Ovulation was observed at 2nd month in group A was 16 (53.3%) and in group B 13 (43.3%). In 3rd months ovulation was seen in 19 patients (63.3%) of group A and 18 patients (60%) of group B. Stratification for age and BMI was also carried out. Conclusion: This study could not find any clinical superiority for clomiphene citrate plus N-acetyl cysteine versus clomiphene citrate alone in term of ovulation rate. Keywords: N-acetyl cysteine, Polycystic ovary syndrome, Ovulation induction

scholarly journals EFFECTIVENESS OF LIFESTYLE MODIFICATION ON WEIGHTLOSS AND QUALITY OF LIFE IN OBESE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

2018 ◽  
Vol 11 (9) ◽  
pp. 333
Author(s):  
Vinaya Rajendra Patil ◽  
Poovishnu Devi Thangavelu ◽  
Vaishali Krishnat Jagtap
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Polycystic Ovarian Syndrome ◽  
Lifestyle Modification ◽  
Obese Women ◽  
Group A ◽  
Conventional Physiotherapy ◽  
Group B ◽  
Ovarian Syndrome

Objectives: (1) The objectives of this study were to determine the effectiveness of lifestyle modification on weight loss and the quality of life in obese women with the polycystic ovarian syndrome and (2) to determine the effectiveness of conventional physiotherapy on weight loss and the quality of life in obese women with polycystic ovarian syndrome.Methods: Ethical clearance was obtained from the Institutional Ethical Committee. A total of 40 obese women with the polycystic ovarian syndrome (PCOS) were selected and divided into two groups, Group A (N=17) received conventional physiotherapy alone, and Group B (n=15) received lifestyle modification along with conventional physiotherapy. The preassessment of body weight is measured by body mass index (BMI); the waist-hip ratio (W-H ratio) and body fat percentage and the quality of life were scored as per the PCOS questionnaire (PCOSQ); and postinterventional assessment was taken for the same after 9 months.Result: Intergroup statistical analysis for BMI revealed extremely significant in postintervention for Group B (P<0.0001). W-H ratio and PCOSQ were extremely significant for Group B (P<0.0001). While postintervention analysis showed extremely significant difference between Group A and Group B (P<0.0001). Group B treated with lifestyle modification, and conventional physiotherapy was extremely significant.Conclusion: Lifestyle modification with conventional physiotherapy helped in reducing weight and showed the increased quality of life in women with PCOS.

scholarly journals COMPARISION OF MYO-INOSITOL VERSUS METFORMIN ON ANTHROPOMETRIC PARAMETERS IN POLYCYSTIC OVARIAN SYNDROME IN WOMEN

2017 ◽  
Vol 9 (4) ◽  
pp. 144 ◽  
Author(s):  
Jyoti Nehra ◽  
Jyoti Kaushal ◽  
Savita Rani Singhal ◽  
Veena Singh Ghalaut
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Hip Circumference ◽  
Anthropometric Parameters ◽  
Insulin Sensitizers ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B ◽  
To Receive ◽  
Ovarian Syndrome

Objective: The objective of the study was to evaluate and compare the effect of insulin sensitizers i.e. metformin and myoinositol on anthropometric parameters in patients of the Polycystic ovarian syndrome (PCOS).Methods: A prospective, open-labeled, randomized, comparative, clinical study was conducted on 60 patients. The patients were randomly divided into two groups of 30 each to receive either of the following two treatments: group A: Tablet myoinositol 1g twice daily. group B: Tablet metformin 500 mg thrice daily for 24 w. Anthropometric parameters were assessed by measuring body weight, Body mass index (BMI), waist circumference, hip circumference, waist-hip ratio (WHR) at baseline and subsequently at the end of 12 w and 24 w.Results: In both the groups, there was a statistically significant improvement in over a period of 24 w. In group A, the values for weight at baseline, 12 w and 24 w expressed in mean±SEM are 63.96±.90, 62.33±.88 and 61.20±.85 while in group B the values were 63.58±1.88, 62.26±1.74 and 60.86±1.65. In group A, the values for BMI at baseline, 12 w and 24 w were 26.45±.41, 25.78±.42 and 25.31±.40 while in group B the values were 26.09±.76, 25.53±.71 and 24.96±.68 respectively. In group A, WHR values were 0.79±.007, 0.78±.007 and 0.78±.007 while in group B 0.79±.010, 0.79±0.108, 0.79±.011 at baseline, 12 w and 24 w respectively. However, on comparing both the groups at 12 and 24 w, no statistically significant difference was observed in all the parameters.Conclusion: There was a definite improvement in anthropometric parameters with both metformin and myoinositol but on comparing these drugs, no significant difference was observed. Thus, myoinositol can also be used as an alternative to metformin for the treatment of PCOS.

scholarly journals Is Surrogate LH Surge Essential in All Induced Cycles?

2013 ◽  
Vol 26 (2) ◽  
pp. 72-76
Author(s):  
Mosammat Rashida Begum ◽  
Mariya Ehsan ◽  
Mosammat Shahina Begum ◽  
Farzana Khan ◽  
Maruf Siddiqi ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Outcome Measure ◽  
Follicular Development ◽  
Target Population ◽  
Treated Group ◽  
Hormone Production ◽  
Main Outcome Measure ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome

Objective: Aim of this study was to identify the necessity of use of exogenous or surrogate  LH for triggering of ovulation in induced cycles. Materials and methods: This study was conducted in Infertility Care and Research Center (ICRC) Dhaka, Bangladesh. Three hundred anovulatory patients with polycystic ovarian syndrome (PCOS) were the target population for this study. The patients were treated by  different ovulation inducing agents to produce mature follicles. When follicle got the size of 18 mm or more LH was given to 150 patients (Group A) and 150 patients did not receive LH (Group B). Follicular rupture was monitored by USG. Main outcome measure was rupture of the follicle.Result: In group A 33.33% and in group B 34.67% patients responded by letrozole only, whereas 66.66% in group A and 65.34% in group B needed additional drugs like metformin glucocorticoids and gonadotropins. In both the groups response was similar in terms of number of follicular recruitment, follicular maturity, endometrial development and hormone production. Follicular rupture rate was similar in both hCG and non-hCG treated group. LUFS was detected only in 2.67% in group A and 2% cases in group B.Conclusion: If follicular development is adequate exogenous LH is not necessary for triggering of ovulation in all stimulated cycles. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13783 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 72-76  

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