Azargoon Azam, Ghorbani Raheb, Faraji Zahra
Department of infertility, Semnan University of Medical Sciences, Semnan, Iran.
Department of Community Medicine, Semnan University of Medical Sciences, Semnan, Iran.
J Family Reprod Health. 2013 Dec;7(4):165-70.
The aim of this study is to determine if simvastatin pretreatment would change clomiphene response in clomiphene citrate-resistant (CC-R)women with (PCOS).
This quasi experimental study included twenty five clomiphene resistant women with PCOS. All patients received cyclic oral contraceptives pills (OCP) (30µg of ethinyl estradiol and 150µg of desogestrol) from the 5th day of their spontaneous or progesterone (P) induced menstrual cycle; in addition, they received simvastatin (20mg/day) from the first day of cycle for two consecutive months. Then, patients were given 100 mg clomiphene citrate (CC) (Iran Hormone, Iran) for five days starting from day three of their menstrual cycles. The primary outcome measures were ovulation and pregnancy rates. The change in body mass index (BMI), the mean number of follicles ≥ 18 mm, the mean of follicular size and endometrial thickness on the day of human chorionic gonadotropin (HCG) administration were secondary outcome measures.
Ovulation occurred in 5 out of 25 (20%) patients, but none of the patients conceived in this study. No important change in BMI was observed after using simvastatin (0.28 + 1.13; p = 0.228). In all patients with ovulation, the number of follicles ≥ 18mm was one. The mean follicular size and endometrial thickness on the day of HCG administration were 19.67 ± 2.04 and 7.00 ± 1.34, respectively.
In this study, we did not observe the favorable effect on ovulation and pregnancy rates with CC following of simvastatin pretreatment in CC-resistant PCOS women. So, further studies with a larger number of patients, higher doses of CC and more cycles are necessary to make this obvious.
本研究旨在确定辛伐他汀预处理是否会改变枸橼酸氯米芬抵抗（CC-R）的多囊卵巢综合征（PCOS）女性对氯米芬的反应。
这项准实验研究纳入了25名氯米芬抵抗的PCOS女性。所有患者在自然月经周期或孕激素（P）诱导的月经周期的第5天开始接受复方口服避孕药（OCP）（30μg炔雌醇和150μg去氧孕烯）；此外，从周期的第一天开始，她们连续两个月每天服用辛伐他汀（20mg）。然后，从月经周期的第三天开始，患者服用100mg枸橼酸氯米芬（CC）（伊朗激素公司，伊朗），持续五天。主要观察指标为排卵率和妊娠率。次要观察指标包括体重指数（BMI）的变化、≥18mm卵泡的平均数量、人绒毛膜促性腺激素（HCG）给药当天的卵泡平均大小和子宫内膜厚度。
25名患者中有5名（20%）发生排卵，但本研究中无患者受孕。使用辛伐他汀后，BMI未观察到显著变化（0.28 + 1.13；p = 0.228）。所有排卵患者中，≥18mm卵泡数量均为1个。HCG给药当天的卵泡平均大小和子宫内膜厚度分别为19.67 ± 2.04和7.00 ± 1.34。
在本研究中，我们未观察到辛伐他汀预处理后CC对CC抵抗的PCOS女性的排卵率和妊娠率有有利影响。因此，需要进行更多患者、更高剂量CC和更多周期的进一步研究来明确这一点。
