Gonadotoropin levels and diabetes-related factor in the polycystic ovarian syndrome

Abstract

OBJECTIVE: Although clomiphene citrate (CC) is often the first choice for ovulation induction in patients with polycystic ovarian syndrome (PCOS), its efficacy is reported to be about 60%. Furthermore, in the clinical setting, its efficacy varies between patients. Therefore, we evaluated laboratory factors as an index for deciding primary patient treatment. DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 66 PCOS patients were evaluated (CC 50: 36 patients; Two Step: 10 patients; CC 100: 20 patients). CC (50 mg/day) was given beginning on cycle day five for five days and ultrasound was performed on cycle day 12 for the confirmation of follicular growth. If follicular growth was inadequate, another CC (50 mg/day) was given beginning on cycle day fifteen for five days (Two Step). In cases in which neither of the aforementioned was effective, CC100 mg was administered. In all patients, baseline serum FSH, LH, BS, DHEA-S, insulin, and BMI were measured. RESULTS: Serum LH was higher in the CC 50 Group than it was in the Two Step Group and the LH/FSH ratio was significantly higher. The BMI, insulin, BS, and the HOMA index were significantly higher in the 2stepGroup than they were in the CC 50 Group. A strong correlation was found between DHEA-S and the LH/FSH ratio in the CC 50 Group but not in the CC 100 Group. CONCLUSIONS: Although further investigation is indicated, this study suggests that it may be possible to formulate an initial treatment protocol using laboratory data in PCOS patients.