الفهرس 
Polycystic Ovary Syndrome (PCOS)
Hirsutism and acneOnly 14 pages are availabe for public view
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Abstract
Polycystic ovary syndrome (PCOS) is the most common
endocrine disorder of reproductive-aged women. It is
characterized by androgen excess, chronic oligoanovulation
and polycystic ovaries (PCO) on ultrasound.
Women with polycystic ovary syndrome (PCOS)
frequently suffer from metabolic disturbances, in particular
from insulin resistance. Accumulating evidence suggests that
vitamin D deficiency may contribute to the development of
insulin resistance. Hence, we aimed to examine the effect of
vitamin D supplementation on metabolic and endocrine
parameters in PCOS women.
Objective:
To assess effects of daily vitamin D3 and calcium
supplementation for 3months on total testosterone level in
women with polycystic ovary syndrome.
Patient and methods:
2 Groups of Women complaining of PCOs and
infertility. Group1 received Vitamin D3 800IU and Ca
1000mg) (Ostoval tablets) treatment for 3 months (this dose to
avoid toxicity and side effects of other high doses) beside
metformin 1500mg per day, Group2 received metformin
1500mg per day only all are diagnosed and have all the inclusion and exclusion criteria, all cases recruited from
outpatient gynecology clinics at Ain Shams University
Maternity hospital after the purpose of the study is clearly
explained and consent is obtained from all women enrolled in
the study along with routine consent as governed by the
hospital rules, Patients were followed up at first and 3 months
later for evaluating total testosterone level and insulin
resistance test (HOMA) (fasting insulin and fasting glucose).
Results:
Calcium plus vitamin D supplementation for 3 months
among women with PCOS had beneficial effects on serum
insulin levels, HOMA-IR, total testosterone level and clinical
findings e. ghirsutism, menstrual regularity and ovulation.
In acomparison between two groups of women with
PCOs in our study the interventional group (3 months
supplementation of calcium, vitamin D and metformin)
showed significant statistical differences as regards
biochemical and clinical outcomes after treatment compared
to control group (3 months metformin treatment).
Insulin level (P value=0.042), insulin resistance index
(P value=0.010) and total testosterone level after treatment (P
value=0.005).Menstrual regularity (p value=0.019), ovulation (p
value =0.025), hirsutism score (p value =0.016).
Before treatment there was no significant statistical
difference between the two groups as regards clinical
outcomes: menstrual regularity (p value =0.117), ovulation,
hirsutism score (p value=0.456).
Also there was no significant statistical difference
between the two groups as regards biochemical measurements:
blood glucose (p value= 0.319), insulin level (p value=0.590),
insulin resistance index (p value= 0.980) and total testosterone
level (p value=0.620) before treatment.
After treatment there was significant statistical
difference (improvement in the interventional group) as
regards menstrual regularity (p value =0.019), ovulation (p
value=0.025), hirsutism score (p value=0.016).
Also there was significant statistical difference
between the 2 groups as regards, insulin level (P
value=0.042), insulin resistance index (P value=0.010) and
total testosterone level after treatment (P value=0.005).
In the control group there was no significant
statistical difference as regards hirsutism score before and
after treatment (PV=0.597).In the control group there was no significant statistical
difference as regards blood glucose (PV=0.864)., insulin level
(PV=0.840)., insulin resistance index (PV=0.680). And total
testosterone level (PV=1.000) before and after treatment.
In interventional group there was significant statistical
difference as regards blood glucose (PV=0.012), Also there
was significant statistical difference between pre and post
treatment in insulin level (P V =0.035).
Insulin resistance: there was significant statistical
difference between pre and post treatment in insulin level
(P V =0.042).
Total testosterone level: there was significant
statistical differences between pre and post treatment (P V
=0.007).
This randomized controlled study was conducted at
Ain-Shams University Maternity Hospital and participants
were recruited from the infertility clinic from the period of
April 2014 to June 2015.
The studied women were subjected to full gynecological
history laying stress on menstrual history and infertility, full
examination laying stress on anthropometric measurements and
body hair distribution according to Ferriman- Gallwey Scale and
investigation including: total testosterone, fasting blood glucose,
fasting insulin.