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Korean Journal of Obstetrics & Gynecology 2006;49(6):1285-1293.
Published online June 1, 2006.
Effects of rosiglitazone on ovarian stromal blood flow, ovarian stimulation and outcome in patients with polycystic ovary syndrome undergoing in vitro fertilization.
Sa Ra Lee, Chung Hoon Kim, Hyuk Jae Kang, Jin Hee Kim, Seok Ho Hong, Sung Hoon Kim, Hee Dong Chae, Byung Moon Kang
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. chnkim@amc.seoul.kr
Abstract
OBJECTIVE
We investigated to evaluate the effects of rosiglitazone on intraovarian stromal blood flow, ovarian response to stimulation, and in vitro fertilization-embryo transfer (IVF-ET) outcome in polycystic ovary syndrome (PCOS) patients. METHODS: Forty-six infertile women, 24 to 36 years of age, with only tubal factor and PCOS, were randomized into either rosiglitazone (n=23) or placebo (n=23) treatment group. A rosiglitazone of 4 mg once daily was started on day 1 of the cycle prior to gonadotropin releasing hormone (GnRH) agonist suppression, and continued to the day of human chorionic gonadotropin (hCG) injection in study group. For a control Group, placebo was administered during the same period. Each of the 2 groups consisted of 23 cycles of IVF-ET. Transvaginal color Doppler analyses (resistance index (RI) and pulsatility index (PI)) were performed to assess the intraovarian stromal blood flow in all participants on the starting days of rosiglitazone or placebo (RI0, PI0), GnRH agonist administration (RI1, PI1) and ovarian stimulation (RI2, PI2). RESULTS: There were no significant differences in age, body mass index (BMI), infertiliy duration, endocrine profile, fasting and 2-hour glucose levels after a 75 gm glucose load, RI0 and PI0 values of ovarian stromal artery between two groups. RI1 and PI1 values were higher in study group, but the differences were not statistically significant. RI2 and PI2 values in study group were significantly higher than in control group (0.60+/-0.04 versus 0.56+/-0.03; P<0.05, 0.99+/-0.14 versus 0.88+/-0.05; P<0.05, respectively). The number of follicles both 10-14 mm and > or =14 mm in diameter on the day of hCG injection and the number of retrieved oocytes were significantly lower in study group. The number of retrieved oocytes was significantly higher in study group. The clinical pregnancy rate was higher in study group but it did not make statistical significance. CONCLUSIONS: Rosiglitazone therapy could reduce the intraovarian stromal blood flow and appeared to be beneficial in improving response to ovulation induction and IVF outcomes in PCOS patients.
Key Words: PCOS, Anovulation, Hypersinsulinemia, Hyperandrogenism, Infertility


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