الفهرس 
Polycystic Ovary SyndromeOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders that cause subfertility. It is frequently associated with insulin resistance (IR) and compensatory hyperinsulinemia. The hyperinsulinemia reportedly contributes significantly to the development of ovarian hyperandrogenism and chronic anovulation commonly encountered in women with PCOS.
Medical ovulation induction with clomiphene citrate is at present the first-line treatment for anovulatory women. There have been randomized placebo-controlled studies published in the literature about adding insulin sensitizers to clomiphene citrate in ovulation induction but their results are conflicting.
In this randomized controlled trial we enrolled a total of 179 infertile obese women with PCOS that came to ain shams maternity hospital, at the infertility clinic sought pregnancy, 128 patients completed screening, 106 patients met the inclusion criteria ,out of them 81 patients completed the follow up while 25 patients were lost during the follow up.
The participants were divided into 3 groups; group 1(control) received clomiphene citrate 100 mg per day for 5 days beginning on the third day of spontaneous or induced menses. Group 2 (cases) received clomiphene citrate 100 mg per day for 5 days beginning on the third day of spontaneous or induced menses with metformin 850mg twice per day at breakfast and dinner. Group 3 (cases) received clomiphene citrare 100 mg per day for 5 days beginning on the third day of spontaneous or induced menses with pioglitazone 30 mg per day at breakfast.
Folliculometry by (transvaginal ultrasound) starting form cycle day 9 and repeated at interval of 2 days. HCG (10000 IU) was given intramuscular when at least one follicle ≥18mm. Patient was then advised to have intercourse 24 to 36 hrs after hCG injection. Serum Beta hCG was measured 16 days after hCG injection to diagnose pregnancy.
There were no significant differences between the three groups regarding age, BMI, hirsutism, husband semen analysis and hormonal assays, denoting that the three groups were matched regarding factors that may affect the induction of ovulation and achievement of pregnancy.
The three groups then were compared regarding Successful biochemical pregnancy, no. of mature follicles and side effects of the prescribed drugs.
On comparing the 3 groups as regard number of mature follicles and side effect of the drugs there was no significant differences.
On comparing the 3 groups as regard biochemical pregnancy, 2 women (7.4%) in group 1 had a positive biochemical pregnancy, 3 (11.1%) women in group 2 had a positive biochemical pregnancy and 5 women (18.5%) in group 3 had a positive biochemical pregnancy which is statistically insignificant.