Department of Obstetrics and Gynaecology, Room No. 3085, 3rd Floor, Teaching Block, All India Institute of Medical Sciences, New Delhi, 110029, India.
Arch Gynecol Obstet. 2010 May;281(5):939-44. doi: 10.1007/s00404-009-1305-8. Epub 2009 Dec 3.
Rosiglitazone, an insulin sensitizing agent is used currently in women with clomiphene citrate (CC) resistant polycystic ovarian syndrome (PCOS). Our study proposed to compare the efficacy of rosiglitazone and CC with laparoscopic ovarian drilling (LOD) and CC in terms of biochemical effects, ovulation rate and pregnancy rate in patients of PCOS resistant to CC.
This prospective randomised trial included 43 patients of PCOS resistant to CC. Twenty-two women were assigned to the rosiglitazone (4 mg twice daily) and CC group and other 21 patients underwent unilateral LOD and then received CC and multivitamins. The treatment continued for six cycles in both the groups. The biochemical response, ovulation rate and pregnancy rate over a follow up period of 6 months were compared.
Treatment with rosiglitazone and CC or LOD and CC resulted in increased ovulation (80.8 vs. 81.5%) and pregnancy (50 vs. 42.8%), respectively. There was no statistical difference between the two groups in terms of biochemical response, ovulation rate and pregnancy rate.
To avoid the risk of adverse effects of LOD preference may be given to the use of rosiglitazone and CC therapy in patients of PCOS resistant to CC.
罗格列酮是一种胰岛素增敏剂，目前用于对枸橼酸氯米酚（CC）耐药的多囊卵巢综合征（PCOS）女性。我们的研究旨在比较罗格列酮和 CC 联合腹腔镜卵巢打孔术（LOD）与 CC 治疗对 CC 耐药的 PCOS 患者的生化效果、排卵率和妊娠率。
这项前瞻性随机试验纳入了 43 例对 CC 耐药的 PCOS 患者。22 名女性被分配到罗格列酮（4mg，每日两次）和 CC 组，另外 21 名患者接受单侧 LOD，然后接受 CC 和多种维生素治疗。两组均持续治疗 6 个周期。比较随访 6 个月期间的生化反应、排卵率和妊娠率。
罗格列酮和 CC 或 LOD 和 CC 治疗均导致排卵增加（80.8%对 81.5%）和妊娠（50%对 42.8%）。两组在生化反应、排卵率和妊娠率方面无统计学差异。
为避免 LOD 的不良反应风险，对 CC 耐药的 PCOS 患者可优先选择使用罗格列酮和 CC 治疗。
