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Effect of Metformin on Endometrial Thickness and Subendometrial Flow Patterns in Anovulatory Patients with Polycystic Ovarian Syndrome

机译:二甲双胍对多囊卵巢综合征无排卵患者子宫内膜厚度和子宫内膜下血流模式的影响

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Background: Polycystic ovarian syndrome (PCOS) is considered the commonest endocrinological disorder affecting reproductive aged women. PCOS compromises fertility through various pathways. These pathways include hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium. It acts by reducing androgen level and correction of insulin resistance. Endometrial vascular indices were evaluated in this study to evaluate endometrial receptivity in anovulatory patients with PCOS. Aim of the Work: To evaluate the outcome of metformin administration in anovulatory patients with PCOS and its effect on the endometrium. This included its role in ovulation and improvement of pregnancy rates. Patients and Methods: This study included 85 patients from Ain Shams University outpatient infertility clinics from 1 ~( st ) of January, 2018 till 30 ~( th ) of June, 2018. We investigated these patients before treatment with ultrasound on day 14, 21. We evaluated endometrial thickness, uterine artery flow pattern, endometrial and subendometrial flow patterns. The patients received metformin 500 mg three times per day for three months. After this duration, we reevaluated them by ultrasound at days 14, 21. Results: Metformin therapy resulted in a significant increase of endometrial thickness and had a significant decrease on uterine, endometrial and subendometrial resistance index (R.I) and pulsatility index (P.I) at day 14, 21 compared to pre-treatment values indicating better blood flow. Conclusion: Metformin therapy resulted in improvement of endometrial flow patterns. Also, it resulted in increase in endometrial thickness and improvement of uterine artery flow.
机译:背景:多囊卵巢综合征(PCOS)被认为是影响生殖老年妇女的最常见的内分泌疾病。 PCOS通过各种途径损害生育能力。这些途径包括雄激素过多症,胰岛素抵抗以及子宫和子宫内膜血流的阻抗。二甲双胍可改善流向子宫内膜的血液。它通过降低雄激素水平和纠正胰岛素抵抗发挥作用。在这项研究中评估了子宫内膜血管指数,以评估无排卵性PCOS患者的子宫内膜容受性。 工作目的:评价二甲双胍在无排卵性PCOS患者中的给药效果及其对子宫内膜的影响。这包括它在排卵和提高妊娠率中的作用。 患者和方法:该研究纳入了Ain Shams大学门诊不育症诊所的85位患者,时间从2018年1月1日至2018年6月30日。我们对这些患者进行了每日超声检查14、21。我们评估了子宫内膜厚度,子宫动脉血流模式,子宫内膜和子宫内膜下血流模式。患者连续三个月每天三次接受二甲双胍500毫克治疗。在此持续时间之后,我们在第14、21天通过超声对其进行了重新评估。结果:二甲双胍治疗导致子宫内膜厚度显着增加,子宫,子宫内膜和子宫内膜下抵抗指数(RI)和搏动指数显着降低(与第14天,第21天的PI)相比,表明治疗前血流更好。 结论:二甲双胍治疗可改善子宫内膜血流模式。而且,其导致子宫内膜厚度的增加和子宫动脉血流的改善。

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