Human Reproduction, Vol 13, 567-570, Copyright © 1998 by Oxford University Press
PO Dale, T Tanbo, E Haug and T Abyholm
In this study we examined the possible correlation between insulin
metabolism and outcome of gonadotrophin stimulation in infertile clomiphene
citrate resistant women with polycystic ovary syndrome (PCOS). The patient
group comprised 42 women who were entered into the study in a consecutive
fashion. Following performance of the CIGMA (continuous infusion of glucose
with model assessment) test, 17 women were classified as insulin resistant
and 25 women as non-insulin resistant. Each woman received up to two cycles
of low-dose follicle stimulating hormone (FSH) stimulation starting with 75
IU of FSH for 1 week, giving a total of 70 cycles performed. The insulin
resistant PCOS women required more gonadotrophin and a longer time to
achieve follicular maturation. By multiple regression gonadotrophin
consumption correlated best with CIGMA value but not with fasting insulin
concentration or body mass index. In the insulin resistant PCOS women 10
out of 29 cycles were cancelled due to a multifollicular response, while
only one of 41 cycles was cancelled in the non-insulin resistant PCOS
women. Although ovulation rate in completed cycles was similar between the
groups, the conception rate was significantly better in the non-insulin
resistant PCOS women. In conclusion, in PCOS women insulin resistance seems
to be an unfavourable condition resulting in an elevated cancellation rate
and a low conception rate following low-dose FSH stimulation.
ARTICLES
The impact of insulin resistance on the outcome of ovulation induction with low-dose follicle stimulating hormone in women with polycystic ovary syndrome
Department of Obstetrics and Gynecology, The National Hospital, Oslo, Norway.
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