Isao Hasegawa, H. Murakawa, Mina Suzuki
Feb 1, 1999
Citations
4
Influential Citations
165
Citations
Quality indicators
Journal
Fertility and sterility
Abstract
OBJECTIVE To investigate the effect of troglitazone, a new antidiabetic agent that improves insulin resistance, on endocrine, metabolic, and ovulatory performance in women with insulin resistance-related polycystic ovary syndrome (PCOS). DESIGN Prospective clinical study. SETTING Infertility outpatient clinic, Niigata University Hospital, Niigata, Japan. PATIENT(S) Thirteen women with PCOS and insulin resistance. INTERVENTION(S) Troglitazone (400 mg/d) was administered for 12 weeks. MAIN OUTCOME MEASURE(S) Insulin and other hormone (gonadotropins, androgens) levels; various parameters relating to glucose and lipid metabolism before, during, and after troglitazone administration; and ovulation rate. RESULT(S) The mean (+/-SD) fasting insulin concentration was significantly reduced, from 18.3+/-8.9 to 10.5+/-7.1 microU/mL. The LH level was reduced from 9.7+/-3.4 to 4.8+/-3.9 mIU/mL and the testosterone level was reduced from 0.9+/-0.5 to 0.5+/-0.3 ng/mL in accordance. Atherosclerotic lipid levels also were normalized. Before troglitazone administration, the ovulation rate during clomiphene citrate therapy was 34.9% per cycle (15/43). This increased significantly to 72.7% (8/11) during troglitazone coadministration. Further, an ovulation rate of 42.3% (11/26) was achieved with troglitazone alone. CONCLUSION(S) In women with PCOS and insulin resistance, the reduction of hyperinsulinemia that is produced by troglitazone improves the hyperandrogenism that characterizes PCOS, restoring ovulation.