ABSTRACT
Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.
Subject(s)
Humans , Female , Adolescent , Adult , Androgens , Anovulation/complications , Clomiphene/therapeutic use , Gonadotropins/metabolism , Infertility, Female/etiology , Ovarian Follicle/physiopathology , Polycystic Ovary Syndrome/physiopathology , Ovarian Function Tests/methods , Neurotransmitter Agents/physiologyABSTRACT
La presente investigación clínica describe los perfiles semiológicos y endocrinológicos de pacientes portadoras del síndrome de Ovario Poliquístico Resistente al Clomífeno (SOP-RC) n=13. Se analizan los nuevos esquemas terapéuticos en el SOP-RC como gonadotrofina coriónica, (hCG); gonadotrofina humana postmenopáusica (HMG), hormona foliculoestimulante (FSH), agonistas del factor liberador de GnRH (aGnRH) en términos de inducción de ovulación y obtención de embarazos. Un 92%de las pacientes ovularon con estas nuevas terapéuticas pero solamente logran embarazo un 53%de ellas. De las 7 pacientes SOP-RC que no logran embarazo con las nuevas terapias recientemente descritas, 5 de ellas lo logran luego de la resección cuneiforme microquirúrgica del ovario. Se destaca el efecto prolongado de la resección cuneiforme del ovario en estas pacientes dado que 4 de ellas logran segundas y terceras gestaciones sin mediar terapia alguna. Los autores concluyen que la resección microquirúrgica cuneiforme del ovario conserva aún su validez en este grupo muy selectivo de pacientes, mejorando la calidad de su ovulación