Prospective observational study on prescribing pattern of infertility treatment options and their success rates in women with polycystic ovary syndrome at tertiary care teaching hospital

Background: Polycystic ovary syndrome or in shortcut PCOS previously called as Stein-Leventhal syndrome is a primary and major cause of anovulatory infertility in women of child bearing ages. 3 in every 5 women with PCOS have trouble getting pregnant. Various therapeutic options are available in managing several PCOS symptoms and in increasing chances of pregnancy. The aim of the study was to observe the prescribing pattern of infertility treatment options and their individual success rates.Methods: The study was conducted in out-patient department of obstetrics and gynaecology, tertiary care teaching hospital, Telangana, India. The study included women aged between 18-37 years who were seeking treatment for infertility due to PCOS. Patients were divided into two categories based on their age and treatment they received which was further grouped accordingly.Results: The frequency of infertility was found to be significantly higher among PCOS women of age group between 23-27 when compared to other age groups. Among infertility treatment options, ovulation induction drugs were mostly prescribed and among supplements folic acid and myo-inositol were widely prescribed as supplements as well as an adjuvant. Patients who received treatment with ovulation inducing drugs showed high success rate.Conclusions: Lifestyle modifications were chosen as primary therapeutic option. Ovulation induction drugs among infertility treatment options, folic acid and myo-inositol among supplements were the mostly prescribed medicines to treat or improve infertility in PCOS women. Ovulation inducing drugs showed high success rate.

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PRESCRIPTION PATTERN IN OBESE AND NON-OBESE INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME IN A TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i3.22936 ◽

2018 ◽

Vol 11 (3) ◽

pp. 53

Author(s):

Asha Avirah Mm ◽

Aswathy Alias ◽

Manjusha Sajith ◽

Vandana Nimbargi ◽

Shivhar Kumdale

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Treatment Options ◽

Tertiary Care ◽

Care Hospital ◽

Lifestyle Modifications ◽

Ovary Syndrome ◽

Infertile Women ◽

Current Medication

Objective: The objective of this study is to evaluate the treatment options for the management of obese and non-obese infertile women with polycystic ovary syndrome (PCOS).Methods: A prospective observational study was conducted with 75 infertile PCOS women. The demographic details, body mass index, menstrual patterns, and current medication related to infertility were noted. The collected data were statistically represented in terms of range, frequency tables, and standard deviation wherever appropriate.Results: A majority of the infertile PCOS women were aged 24–27 years with a mean age of 25.72±3.53 years, belonging to middle socioeconomic class (44%) and mostly found to be urban residents 68%. Most of the PCOS women were overweight (32%) and obese (21%) with irregular menstrual pattern (90.67%). In combination therapy, clomiphene citrate (CC) pre-treated with oral contraceptives (OC) (37.93%) was mostly given to obese PCOS patients followed by CC with metformin pre-administered with OC (31.03%), whilen on-obese PCOS patients were mostly administered CC with gonadotropins pre-treated with OC(44%). In single therapy, OC was mostly administered to both non-obese (90%) and obese PCOS patients (88.90%).Conclusion: This study concluded that most of the infertile PCOS women were overweight and obese, a major risk actor causing hyperandrogenicity. CC pre-treated with OC and metformin with CC pre-treated with OC were mostly prescribed to obese PCOS patients. Lifestyle modifications along with treatment are strongly recommended, especially in obese PCOS patients.

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EFFECT OF AROMATASE INIBITOR IN OVULATION INDUCTION IN FETILE WOMEN WITH POLYCYSTIC OVARY SYNDROME

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.3.12 ◽

2014 ◽

pp. 86-93

Author(s):

Minh Tam Le

Keyword(s):

Polycystic Ovary Syndrome ◽

Ovulation Induction ◽

Polycystic Ovary ◽

Endometrial Thickness ◽

Statistical Significance ◽

Ovulation Rate ◽

Normal Body Mass Index ◽

Ovary Syndrome ◽

Group I ◽

First Choice

Backgrounds: Polycystic Ovary Syndrome (PCOS) is one of the most common causes of female infertility due to ovulation disorders. Clomiphene citrate (CC) is a first choice to restore ovulation but it has some side effects by estrogen receptor down-regulation. Aromatase inhibitor (AI) is a newer class of drugs which increases the production of endogenous FSH to stimulate ovulation. Subjects and methods: randomized control trial to compare 64 cases of infertile women with PCOS examined at the Hue University Hospital, alternately used AI (group I) or CC (group II) for ovulation induction from day 2 cycle. Follow-up follicle growth, endometrium and ovulation via ultrasound. Evaluation were done on 10th day cycle, day of hCG trigger and after administration of hCG. Results: Total of 64 PCOS cases distributed into 2 groups using alternatively AI and CC had similar characteristics with average age of 28.8 ± 4.6, the majority were primary infertility (84.4%), infertility duration was 2.6 ± 2.4 years, 85.9% had oligomenorrhrea or amenorrhea, normal body mass index accounts for 60.9% and 21.9% was lean. Evaluation of both groups on day 10 revealed no differences in the dominant follicle and endometrial thickness. Number of days until the follicle mature appears to be shorter in AI group (15.1 ± 2.9) compared to the CC group (16.5 ± 2.8) with statistical significance. The number of mature follicles in 2 groups were not different at a rate of 81.3% (AI) and 84.4% (CC) but a higher proportion of single mature follicle in the AI group (71.9%) compared with the CC group (65.7%) and There is no case with 3-4 mature follicles in the AI group. The rate of thin endometrium (<8 mm) in the AI group (25%) was lower than the CC group (53.1%) with statistically significance and higher ovulation rate (68.8%) compared with the CC group (56.3%) but have not found statistically significant. Conclusion: Two drugs AI and CC potentially induce follicle development and ovulation similarly, but AI has the potential to be more effective than CC on factors such as the shorter stimulation duration, increasing rate of single follicle, limiting multiple pregnancies, improve endometrial thickness and higher ovulation rate. More researches are needed with a larger sample size to clarify the statistical significance of differences.

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