Department of Biologyt, Faculty of Science, Arak University, Arak, Iran.
Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ir J Med Sci. 2021 May;190(2):685-692. doi: 10.1007/s11845-020-02320-5. Epub 2020 Jul 28.
Insulin resistance plays a major role in the pathogenesis of polycystic ovary syndrome (PCOS). Therefore, there is a growing interest in the use of insulin sensitizer drugs in the treatment of PCOS. Research in recent years has shown that sitagliptin has been reported to improve ovarian cycles and ovulation in PCOS patients.
We aimed to compare the effects of metformin and sitagliptin on PCOS individuals undergoing ICSI.
Sixty PCOS patients were divided into 3 groups: metformin, sitagliptin, and placebo group. Treatment was carried out 2 months before the start of the ovulation cycle and continued until the day of oocyte aspiration. The serum levels of total testosterone, estradiol, and fasting insulin along with the total number of retrieved, normal and abnormal MII, and fertilized oocytes, the number of transferred embryos (grades I, II and III), and biochemical and clinical pregnancy rates as well as the ovarian hyperstimulation syndrome (OHSS) were evaluated.
There was a significant reduction in the serum levels of Insulin and total testosterone in the treated groups compared with the placebo. The number of mature and normal MII oocytes increased significantly in the treated groups compared with the placebo. Moreover, the number of immature oocytes decreased significantly and the number of grade I embryos increases significantly in the sitagliptin group compared with the placebo group.
We conclude that sitagliptin can improve the maturation of oocytes and embryos' quality more effectively than metformin, in PCOS patients undergoing ICSI.
Trial registration is NCT04268563 ( https://clinicaltrials.gov ).
胰岛素抵抗在多囊卵巢综合征（PCOS）的发病机制中起主要作用。因此，人们越来越关注使用胰岛素增敏药物治疗 PCOS。近年来的研究表明，西格列汀已被报道可改善 PCOS 患者的卵巢周期和排卵。
我们旨在比较二甲双胍和西格列汀对接受 ICSI 的 PCOS 个体的影响。
将 60 名 PCOS 患者分为 3 组：二甲双胍组、西格列汀组和安慰剂组。治疗在排卵周期开始前 2 个月进行，并持续到取卵日。检测血清总睾酮、雌二醇和空腹胰岛素水平，以及总获卵数、正常和异常 MII 卵数、受精卵数、移植胚胎数（I 级、II 级和 III 级）、生化和临床妊娠率以及卵巢过度刺激综合征（OHSS）。
与安慰剂组相比，治疗组的血清胰岛素和总睾酮水平显著降低。与安慰剂组相比，治疗组的成熟和正常 MII 卵数显著增加。此外，与安慰剂组相比，西格列汀组的不成熟卵数显著减少，I 级胚胎数显著增加。
我们得出结论，西格列汀可比二甲双胍更有效地改善 PCOS 患者接受 ICSI 时的卵母细胞成熟和胚胎质量。
试验注册 NCT04268563（https://clinicaltrials.gov）。
