Author/Editor | Salobir, B | |
Title | Vpliv insulinske rezistence na izid zdravljenja infertilnosti pri ženskah s sindromom policističnih ovarijev | |
Translated title | Insulin resistance and the outcome of infertility treatment in women with polycystic ovary syndrome | |
Type | monografija | |
Place | Ljubljana | |
Publisher | Medicinska fakulteta | |
Publication year | 1995 | |
Volume | str. 89 | |
Language | slo | |
Abstract | Insulin resitance, polycystic ovaries, infertility and exaggerated response to induction of ovulation with menotrophins are often found in women with polycystic ovary syndrome. Exaggerated response to induction of ovulation can also be observed in women with polycystic ovaries only (PCO). To elucidate the role of insulin resistance and hormonal milieu on the stimulation of ovulation and in-vitro fertilisation we conducted a prospective study. We included 29 patients treated for infertility caused by tubal occlusion (n=25), male factor (n=2) or both abnormalities (n=2). They were under to years of age and with body mass index (IBMI) less than 30 kg/m2. On transvaginal ultrasound examination we found PCO in 16 patients, in 13 the morphology of the ovaries was normal. We determined basal concentrations of glucose, insulin, C-peptide, growth hormone, insulin-like growth factor-I (IGF-I), IGF binding protein (IGFBP)-I and -II, LH, FSH, estradiol, estrone, total testosterone, free testosterone. We performed oral glucose tolerance test (OGTT) and hyperinsulinemic euglycemic clamp. Ovarian stimulation and in-vitro fertilisation were performed in following cycle. Women with PCO had higher BMI, LH, FSH, insulin resistance and serum insulin concentration during steady state of the hyperinsulinemic euglycemic clamp. The difference between the two groups in insulin resistance and serum insulin concentration during steady state phase of clamp was not significant after allowing for BMI and waist/hip ratio (WHR). We found positive correlation between insulin resistance and the ratio of fol licles larger than 16 mm and larger than 10 mm. Insulin in the steady state of the clamp positively correlated with a dose of gonadotrophins used for ovulation induction. All the indirect indicators of insulin resistance were positively correlated with some of the variables of in-vitro fertilisation, among which glucose during OGTT had the strongest correlation.(trunc.) | |
Descriptors | POLYCYSTIC OVARY SYNDROME INFERTILITY, FEMALE TREATMENT OUTCOME INSULIN RESISTANCE OVULATION INDUCTION EMBRYO TRANSFER FERTILIZATION IN VITRO MENOTROPINS |