Effect of pretreatment with compound cyproterone acetate-metformin combination on the outcome of ovulation induction in the infertility women with polycystic ovarian syndrome

摘要

Objective: To observe the effects of compound cyproterone acetate (Daine-35) in combination with metformin on the endocrinologic, metabolic changes and the outcomes of ovulation induction in the infertility women with polycystic ovarian syndrome (PCOS). Methods: A prospective study recruited 65 PCOS patients and 30 non-PCOS infertility women. The body mass index (BMI), waist: hip ratio (WHR), Ferriman-Gallwey score, gonadotrophin, testosterone (T), fasting glucose, fasting insulin, triglyceride, total cholesterol, apoA, apoB and HDL-cholesterol were determined in all patients before the treatment and served as the baseline. At the end of 12-week therapy, these parameters were re-measured. 50 PCOS infertile patients as study group were treated with combination of Daine-35 with metformin for three months. Clomiphene citrate (CC) and human menopause gonadotrophin (hMG) were added for three cycles to induce ovulation. Other 15 PCOS cases as control group directly underwent ovulation induction with CC and hMG for three cycles. Results: The PCOS patients had higher levels of LH, T, E2, fasting insulin, FG/FI, total cholesterol and triglyceride, and lower levels of HDL-cholesterol when compared with the non-PCOS women (P<0.001-P<0.05). After treatment, the levels of LH, T, E2 were significantly decreased (58.9%, 38% and 30.1%, respectively) and the levels of apoB and HDL-C were significantly increased (17.2% and 20%, respectively) in the study group (P<0.001-P<0.05). FI and FG/FI showed a slight change in the study group, but no significant difference was found. The rates of ovulation and pregnancy were higher than those in control group (71% vs 60.5% and 38% vs 13.3%, respectively).Conclusions: Metformin in combination with compound cyproterone acetate (Daine-35) therapy may normalize the endocrine and metabolic abnormalities, and improve the ovarian response to ovulation induction drugs and increase the pregnancy rate of infertility patients with PCOS.