Dragamestianos Christos, Messini Christina I, Antonakis Pantelis T, Zacharouli Konstantina, Kostopoulou Evanthia, Makrigiannakis Antonis, Georgoulias Panagiotis, Anifandis George, Dafopoulos Konstantinos, Garas Antonios, Daponte Alexandros, Messinis Ioannis E
Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
REA Maternity Hospital, Athens, Greece.
Gynecol Obstet Invest. 2019;84(1):35-44. doi: 10.1159/000491086. Epub 2018 Jul 26.
To investigate the effect of metformin on endometrial receptivity in women with polycystic ovary syndrome (PCOS).
Twenty volunteer women with polycystic ovaries and oligomenorrhea were prospectively investigated. All women were treated with exogenous estradiol and progesterone to simulate a normal menstrual cycle (28-day duration) after GnRH-induced pituitary desensitization. Ten of the women received no other medication (group A, control), while the remaining 10 received metformin (group B, metformin). Endometrial biopsy was performed in all women on day 21 of the 2 simulated cycles.
The expression of corticotropin - releasing hormone and urocortin in the endometrium was investigated. There was no significant difference between the 2 groups. A 3-day delay in the secretory maturation of the glandular epithelium relatively to the stroma was observed in 7 out of 10 women of group B (70%) as compared to only 1 out of 10 women of group A (10%, p = 0.02).
It is shown for the first time that metformin administration to women with PCOS did not affect the expression of endometrial receptivity markers but delayed histological glandular maturation. It is suggested that metformin may have an impact on the function of the endometrium in PCOS.
探讨二甲双胍对多囊卵巢综合征（PCOS）女性子宫内膜容受性的影响。
对20名患有多囊卵巢和月经过少的志愿者女性进行前瞻性研究。所有女性在GnRH诱导垂体脱敏后，接受外源性雌二醇和孕酮治疗以模拟正常月经周期（持续28天）。其中10名女性未接受其他药物治疗（A组，对照组），其余10名接受二甲双胍治疗（B组，二甲双胍组）。在两个模拟周期的第21天对所有女性进行子宫内膜活检。
研究了子宫内膜中促肾上腺皮质激素释放激素和尿皮质素的表达。两组之间无显著差异。与A组10名女性中的1名（10%，p = 0.02）相比，B组10名女性中有7名（70%）观察到腺上皮相对于基质的分泌成熟延迟3天。
首次表明，对PCOS女性给予二甲双胍不影响子宫内膜容受性标志物的表达，但会延迟组织学上的腺体成熟。提示二甲双胍可能对PCOS患者的子宫内膜功能有影响。
