Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Effects of insulin-sensitizing agents and insulin resistance in women with polycystic ovary syndrome

  • Hwang, Kyu Ri (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Choi, Young Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Jin Ju (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Chae, Soo Jin (Maria Fertility Hospital) ;
  • Park, Kyung Eui (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Jeon, Hye Won (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Ku, Seung Yup (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Seok Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Jung Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Moon, Shin Yong (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • Received : 2013.03.09
  • Accepted : 2013.05.24
  • Published : 2013.06.30
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Abstract

Objective: The aim of this study was to investigate the effect of insulin sensitizing agents on hormonal and metabolic parameters as well as menstrual patterns in women with polycystic ovary syndrome (PCOS). Methods: One hundred and twenty-three patients with PCOS were included. Metformin was administered to patients at 1,500 mg or 1,700 mg daily for 3 months. If the patients had no improvement of the menstrual cycle or metformin-related adverse effects developed, the patients changed medication to a daily dose of either 15 mg pioglitazone or up to 45 mg. Then resumption of a regular menstrual cycle or recovery of ovulation was evaluated. Hormonal and metabolic profiles were compared between the response and non-response group to insulin sensitizing agents. Results: One hundred and five patients with PCOS were treated with metformin for 3 months. Forty-eight patients (45.7%) showed improvement of menstrual cycle regularity after 3 months of metformin use, whereas 57 patients (54.3%) had no change. The mean free testosterone measured after 3 months of treatment was significantly lower in metformin responders than in non-responders. The other parameters did not differ between the groups. Of the 23 patients who used pioglitazone for 3 to 6 months, 19 patients (82.6%) showed improvement in their menstrual cycles. Conclusion: Metformin treatment seems to be effective for the improvement of menstrual cyclicity irrespective of insulin resistance in women with PCOS. When metformin related adverse effect occurred, pioglitazone would be effective for aiding the resumption of the menstrual cycle.

Keywords

References

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