Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
Fertil Steril. 2010 Jun;94(1):236-41. doi: 10.1016/j.fertnstert.2009.02.029. Epub 2009 Mar 26.
To investigate the effects of pioglitazone on ovarian stimulation, in vitro fertilization (IVF) outcome, and intraovarian stromal blood flow in patients with polycystic ovary syndrome (PCOS).
Prospective, randomized, controlled trial.
University-affiliated infertility clinic.
PATIENT(S): Sixty infertile patients with PCOS resistant to clomiphene citrate.
INTERVENTION(S): An IVF protocol involving use of a gonadotropin-releasing hormone (GnRH) antagonist and oral contraceptive pretreatment. Patients were randomized into two groups: pioglitazone (30 mg daily) in the study group or placebo in the control group, commenced on the day on which oral contraceptive intake began.
MAIN OUTCOME MEASURE(S): Ovarian stimulation, IVF outcome, and resistance index of the intraovarian stromal artery.
RESULT(S): The resistance index value on the day of human chorionic gonadotropin (hCG) injection in the study group was statistically significantly higher in the study group than in controls. The serum estradiol level and number of retrieved oocytes were statistically significantly lower in women treated with pioglitazone. However, the number of mature oocytes and fertilized oocytes, and the clinical pregnancy rate were similar in both groups.
CONCLUSION(S): Pioglitazone therapy reduced intraovarian stromal blood flow and might be beneficial in improving both the response to ovarian stimulation and IVF outcome in PCOS patients.
探讨吡格列酮对多囊卵巢综合征（PCOS）患者卵巢刺激、体外受精（IVF）结局和卵巢内间质血流的影响。
前瞻性、随机、对照试验。
大学附属不孕不育诊所。
60 例对枸橼酸氯米酚耐药的 PCOS 不孕患者。
涉及使用促性腺激素释放激素（GnRH）拮抗剂和口服避孕药预处理的 IVF 方案。患者随机分为两组：研究组口服吡格列酮（每天 30mg），对照组口服安慰剂，均从开始口服避孕药的那天开始。
卵巢刺激、IVF 结局和卵巢内间质动脉阻力指数。
人绒毛膜促性腺激素（hCG）注射日研究组的阻力指数值明显高于对照组。接受吡格列酮治疗的女性血清雌二醇水平和获卵数明显降低。然而，两组的成熟卵数和受精卵数以及临床妊娠率相似。
吡格列酮治疗可降低卵巢内间质血流，可能有助于改善 PCOS 患者的卵巢刺激反应和 IVF 结局。
