The ovulation effect of ethinylestradiol and cyproterone acetate combined with metformin on obesity type polycystic ovary syndrome

Abstract

Objective To evaluate the ovulation effect of ethinylestradiol and cyproterone acetate combined with metformin on obesity type polycystic ovary syndrome (PCOS).Methods Sixty-two patients with obesity type PCOS were divided into 2 groups by random digits table method:control group (30 cases) was treated with letrozole;observation group (32 cases) was treated with letrozole after 3 months treated with ethinylestradiol and cyproterone acetate combined with metformin.The weight,body mass index (BMI),glycometabolism indexes [fasting plasma glucose (FPG),fasting insulin (FINS) and homeostasis model of assessment for insulin resistance index (HOMA-IR)],hormone [follicle-stimulating hormone (FSH),luteotrophic hormone (LH),estradiol (E2) and testosterone (T)] before and after treatment and ovulation rate and pregnancy rate were compared between 2 groups.Results There were no statistical differences in weight,BMI,FPG,FINS and HOMA-IR in control group between before treatment and after treatment (P ＞ 0.05).The indexes in observation group after treatment were significantly lower than those before treatment [(55.76 ± 2.69) kg vs.(64.42 ± 4.93) kg,(21.52 ± 1.43) kg/m2 vs.(25.74 ± 1.58) kg/m2,(4.46 ± 0.89) mmol/L vs.(5.69 ± 2.01) mmol/L,(12.24 ± 1.82) mU/L vs.(22.88 ± 2.06) mU/L,2.94 ± 1.76 vs.5.27 ± 1.18],there were statistical differences (P＜ 0.05).There were no statistical differences in FSH and E2 in 2 groups between before treatment and after treatment (P ＞ 0.05).There were no statistical differences in LH and T before treatment between 2 groups (P ＞ 0.05),but after treatment were significantly lower than before treatment [control group:(10.33 ±0.57) mU/L vs.(15.63 ± 1.32) mU/L and (1.22 ±0.96) μg/L vs.(2.21 ± 1.24) μ g/L;observation group:(9.07 ± 0.82) mU/L vs.(16.18 ± 1.24) mU/L and (0.71 ± 1.24) μ g/L vs.(2.43 ± 1.52) μ g/L],furthermore the observation group was lower,there were statistical differences (P ＜ 0.05).The ovulation rate and pregnancy rate in observation group were significantly higher than those in control group [78.12％(25/32) vs.53.33％(16/30) and 53.12％(17/32) vs.26.67％(8/30)],there were statistical differences (P ＜ 0.05).Conclusion Ethinylestradiol and cyproterone acetate combined with metformin is more effective on obesity type PCOS,which can improve the ovulation rate and pregnancy rate. Key words: Metformin; Polycystic ovary syndrome; Ethinylestradiol and cyproterone acetate