Holzer Iris, Parry John Preston, Beitl Klara, Pozderovic Boban, Marculescu Rodrig, Ott Johannes
Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Parryscope and Positive Steps Fertility, Madison, WI 39110, USA.
J Clin Med. 2022 May 5;11(9):2597. doi: 10.3390/jcm11092597.
For women with polycystic ovarian syndrome (PCOS) and infertility, stimulation with the aromatase-inhibitor letrozole has been recommended as a first-line for ovulation induction. Calcium-associated signaling has also been a component for other ovulation induction and superovulation medications. This study’s aim was to evaluate parameters of calcium metabolism in PCOS women. In a prospective cohort study, 61 anovulatory, infertile PCOS patients who underwent letrozole stimulation were included. Outcome measures were: follicular maturation after letrozole stimulation; parathyroid hormone (PTH); 25-hydroxyvitamin D3 (25OHD3); serum levels of calcium, phosphorus, magnesium, albumin, and total protein. Successful recruitment of a dominant follicle was achieved in 35 patients (57.4%). Women with and without successful follicular development did not differ in serum levels of PTH (38.4 ± 19.7 vs. 39.6 ± 16.2 pg/mL), 25OHD3 (62.5 ± 32.1 vs. 65.4 ± 30.9 nmol/L), calcium (2.36 ± 0.08 vs. 2.37 ± 0.12 mmol/L), or protein (70.2 ± 13.3 vs. 74.0 ± 3.7 g/L), respectively (p > 0.05). However, women who were not responsive to letrozole for ovulation induction demonstrated higher anti-Müllerian hormone (AMH) levels (9.7 ± 4.7 vs. 5.0 ± 3.2 ng/mL, p = 0.005). In conclusion, the success of letrozole stimulation in women with PCOS is independent from calcium metabolism parameters. However, AMH levels seem predictive of medication resistance.
对于患有多囊卵巢综合征（PCOS）且不孕的女性，芳香化酶抑制剂来曲唑刺激已被推荐作为诱导排卵的一线治疗方法。钙相关信号传导也是其他诱导排卵和超排卵药物的一个组成部分。本研究的目的是评估PCOS女性的钙代谢参数。在一项前瞻性队列研究中，纳入了61例接受来曲唑刺激的无排卵、不孕的PCOS患者。观察指标包括：来曲唑刺激后的卵泡成熟情况；甲状旁腺激素（PTH）；25-羟基维生素D3（25OHD3）；血清钙、磷、镁、白蛋白和总蛋白水平。35例患者（57.4%）成功募集到优势卵泡。卵泡发育成功和未成功的女性在PTH血清水平（38.4±19.7 vs. 39.6±16.2 pg/mL）、25OHD3（62.5±32.1 vs. 65.4±30.9 nmol/L）、钙（2.36±0.08 vs. 2.37±0.12 mmol/L）或蛋白质（70.2±13.3 vs. 74.0±3.7 g/L）方面无差异（p>0.05）。然而，对来曲唑诱导排卵无反应的女性抗苗勒管激素（AMH）水平较高（9.7±4.7 vs. 5.0±3.2 ng/mL，p = 0.005）。总之，来曲唑刺激对PCOS女性的成功与否独立于钙代谢参数。然而，AMH水平似乎可预测药物抵抗情况。
