Raja Ayisha, Hashmi Shoaib Naiyar, Sultana Nadra, Rashid Haroon
Department of Gynaecology and Obstetrics, Combined Military Hospital Badin Cantt, Sindh.
J Ayub Med Coll Abbottabad. 2005 Apr-Jun;17(2):50-3.
This study was carried out to determine the pattern of presentation of Polycystic ovary syndrome (PCOS) in patients presenting at our unit and to compare effects of clomiphene alone and in combination with metformin in management of PCOS.
This study was conducted from Jan 2001-2003 at Military Hospital, Rawalpindi. All patients presenting with infertility were evaluated with a view to select 100 patients of PCOS with the help of history of oligomenorrhoea, hirsuitism and acne. Diagnosis was confirmed by ultrasonography and hormone analysis (LH, FSH, prolactin, testosterone along with LH:FSH>2). The 100 selected patients were divided into two equal groups. One was given combined clomiphene citrate (CC) and metformin for ovulation induction and the other CC alone. These patients were followed for six cycles for ovulation and conception. Follicle tracking on ultrasonography and day-21 serum progesterone level were used to detect ovulation while conception was confirmed by urine pregnancy test, serum B-HCG level and ultrasonography for gestational sac.
Hirsuitism and oligomenorrhoea were the two most common clinical features of PCOS. In the first group 34 patients (68%) ovulated as compared with 18 (36%) in the second group. In the first group 18 out of 34 women (52.9%) conceived as compared with only 8 out of 18 (44%) in the second group. The difference was significant at >0.05 when ovulatory and pregnancy responses were compared among two groups. All patients tolerated metformin well and no teratogenic effects were observed in patients who conceived after treatment with metformin.
A combination of metformin and clomiphene citrate significantly increases the ovulation and conception rates in these patients.
本研究旨在确定在我院就诊的多囊卵巢综合征（PCOS）患者的临床表现模式，并比较单独使用克罗米芬以及克罗米芬与二甲双胍联合使用对PCOS的治疗效果。
本研究于2001年1月至2003年在拉瓦尔品第军事医院进行。对所有不孕患者进行评估，以便在有月经过少、多毛症和痤疮病史的帮助下选择100例PCOS患者。通过超声检查和激素分析（LH、FSH、催乳素、睾酮以及LH:FSH>2）确诊。将100例入选患者分为两组，每组人数相等。一组给予枸橼酸克罗米芬（CC）和二甲双胍联合诱导排卵，另一组仅给予CC。对这些患者进行六个周期的排卵和受孕跟踪。通过超声检查卵泡跟踪和第21天血清孕酮水平检测排卵，而通过尿妊娠试验、血清β-HCG水平和孕囊超声检查确认受孕。
多毛症和月经过少是PCOS最常见的两个临床特征。第一组34例患者（68%）排卵，而第二组为18例（36%）。第一组34名女性中有18例（52.9%）受孕，而第二组18例中只有8例（44%）受孕。两组间排卵和妊娠反应比较时，差异有统计学意义（P>0.05）。所有患者对二甲双胍耐受性良好，接受二甲双胍治疗后受孕的患者未观察到致畸作用。
二甲双胍和枸橼酸克罗米芬联合使用可显著提高这些患者的排卵率和受孕率。
