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Insulin resistance in clomiphene responders and non‐responders with polycystic ovarian disease and therapeutic effects of metformin
Author(s) -
Parsanezhad M.E,
Alborzi S,
Zarei A,
Dehbashi S,
Omrani Gh
Publication year - 2001
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(01)00470-2
Subject(s) - medicine , polycystic ovarian disease , insulin resistance , metformin , infertility , insulin , endocrine system , endocrinology , prospective cohort study , pregnancy , gynecology , polycystic ovary , hormone , biology , genetics
Objectives : To evaluate the clinical features, endocrine and metabolic profiles in clomiphene (CC) responders and non‐responders with polycystic ovarian disease (PCOD), and to examine the effects of metformin (MTF) on the above parameters of CC resistance. Methods : A prospective clinical trial was undertaken at the infertility division of a university teaching hospital. Forty‐one CC responders were selected and their hormonal and clinical features were determined. Forty‐one CC‐resistant PCOD women were also selected and clinical features; metabolic and hormonal profiles before and after treatment with MTF 1500 mg/day for 6–8 weeks were evaluated. Women who failed to conceive were treated by CC while continuing to take MTF. Results : CC responders had higher insulin levels while non‐responders were hyperinsulinemic. Menstrual irregularities improved in 30%. Mean±S.D. area under curve of insulin decreased from 297.58±191.33 to 206±0.1 mIU/ml per min ( P =0.005). Only 39.39% ovulated and 24.24% conceived. Conclusion : PCOD is associated with insulin resistance (IR) particularly in CC‐resistant women. Insulin resistance and androgen levels are significantly higher in obese patients. MTF therapy improved hyperandrogenemia, IR, and pregnancy rate.