Clinical Observation Of Diane-35 Plus Metformin On Infertile Patients With Polycystic Ovary Syndrome

Background and ObjectivePolycystic ovarian syndrome (PCOS) is an ovulatory disease caused by reproductive endocrine and metabolic abnormalities, the incidence rate in women of childbearing age is 5%-10%, and accounts about 70% among anovulatory infertile patients. Recent researches find out that insulin resistance and hyperinsulinemia are the basic pathophysiological features of PCOS and insulin levels and androgen levels are positively correlated. Insulin sensitizers can reduce insulin and androgen levels in peripheral blood, and improve ovulation in patients with PCOS{1,2}. Metformin is the drug which can treat type-2 diabetes and increase insulin sensitivity. Diane-35 contains cyproterone acetate (CAP) and ethinyl estradiol (EE), through a variety of ways to have strong anti-male role. This paper aims to observe the effects of Diane-35 in combination with metformin and Clomiphene citrate (CC), HMG (HMG), human chorionic gonadotropin (HCG) for the treatment of infertile patients with polycystic ovary syndrome.MethodsChoosing 100 infertile patients suffering PCOS which accept treatment in our hospital from January 2007-January 2009, they were randomly divided into group A and group B, each group has 50 patients. Group A was treated with metformin plus Diane-35, group B was treated with Diane-35, the medication time of each group lasts for 3 months. Serum LH (the patients are randomly divided into group A and group B, each group with 50 LH), testosterone (T), fasting and postprandial 2h insulin, fasting and postprandial 2h blood glucose and body mass index (BMI) were measured before and after treatment. From the fourth month, using clomiphene citrate (CC), HMG (HMG), human chorionic gonadotropin (HCG) to induce ovulation and using type-B ultrasonic to monitor ovulation.ResultsFor group A, after treatment, the value of LH, T was significantly lower than pre-treatment (P<0·01), fasting and postprandial 2h insulin was significantly lower than pre-treatment, however, blood glucose, BMI has no significant change compared with pre-treatment; after treatment, the value of LH,T of group B was significantly lower than pre-treatment (P<0·05), while the fasting and postprandial 2h insulin, glucose, BMI has no significant change compared with pre-treatment. The ovulation rate and pregnancy rate of group A were higher than group B.Conclusion:CPA in combination with metformin therapy can improve the effect of ovulation induction and the pregnancy rate, the treatment effect is better than using Diane-35 alone.