Effect of Rosiglitazone on Insulin Resistance, Ovulation and Pregnancy in Women with Polycystic Ovarian Syndrome

Abstract

Objective: To evaluate the effects of rosiglitazone on insulin resistance, reproductive disturbance in women with polycystic ovarian syndrome (PCOS). Design: prospective study.Setting: women with PCOS attending as out patients of private clinic and Baghdad teaching hospital. Patient & Methods: this study included thirty obese PCOS women with an age ranging from (18-37) years old. The body mass index and waist/ hip ratio of patients were calculated before and after 3-6 months of rosiglitazone therapy. Venous blood sample for fasting glucose, fasting insulin, fasting insulin/ fasting glucose ratio, HbA1C, LH, SHBG, DHEA-S, total and free testosterone were evaluated before and after 3-6 months of 4mg daily treatment with rosiglitazone. In addition, Transvaginal ultrasound was done at mid cycle to demonstrate dominate follicle. Midluteal progesterone was also measured to detect ovulation. Result: A significant decrease was observed in serum fasting insulin, fasting glucose/ insulin ratio, DHEA-S, total and free testosterone and waist / hip ratio after 3-6months of rosiglitazone therapy.-BMI (body mass index) remained unchanged. -Six of thirty patients studied reverted regular ovulatory cycle after 3months of treatment while other sixteen patients reverted ovulation after 6 months of treatment. Conclusion: rosiglitazone is a promising insulin sensitizer increase ovulatory frequency and ameliorate hyperandrogemia in obese women with PCOS.Key wards: polycystic ovary syndrome insulin resistance rosiglitazone, ovulation, pregnancy.