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OBJECTIVE:To discuss the effect of Ethinylestradiol and cyproterone acetate tablet combined with metformin on ovulation induction of patients with polycystic ovarian syndrome(PCOS). METHODS:184 PCOS patients were randomly divided into control group(92 cases)and observation group(92 cases). Control group orally received 1 Ethinylestradiol and cyproterone ac-etate tablet in 5 d of menstruation,once a day,it stopped after 21 d,the next cycle of treatment was started on the 5th of with-drawal bleeding. Observation group additionally received 3 Metformin tablet,once a day,without drug withdrawal during menstrua-tion,and lasted for 3 menstrual cycles. After 3 menstrual cycles,all patients received ovulation induction treatment [(50-100 mg clomiphene was orally given from the 5th day of the 4th menstrual cycle,for 5 days,or 75-150 U postmenopausal gonadotropin by intramuscular injection,when the dominant follicle diameter was(19.0±2.0)mm,10 000 U human chorionic gonadotropin(HCG) was intramuscularly injected,the ovulation was continuously monitored and whether there was ovarian hyperstimulation syndrome (OHSS)was observed]. Body mass index(BMI),follicle estrogen(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol (E2)and testosterone(T)before and after treatment,fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance in-dex(HOMA-IR),pregnancy rate,ovulation rate and the incidences of OHSS and adverse reactions in 2 groups were observed.RE-SULTS:Before treatment,there were no significant differences in the BMI,FSH,LH,PRL,E2,T,FPG,FINS and HOMA-IR between 2 groups(P>0.05). After treatment,BMI,LH,PRL,E2,T,FPG,FINS and HOMA-IR in observation group and LH, E2 and FINS in control group were significantly lower than before,and BMI,PRL,E2,T,FPG,FINS and HOMA-IR in observa-tion group were lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Ethinylestradiol and cyproterone acetate combined with metfor-min can effectively improve insulin resistance of POCS patients,recovery sex hormone secretion,promote ovulation and improve pregnancy rate,with good safety.
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Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets(Diane-35)on endocrine metabolism in non-obese women with polycystic ovary syndrome(PCOS). Methods Fifty-three non-obese patients with PCOS were assigned to the 6-month treatment with Diane-35.Body mass index(BMI),waist to hip ratio(WHR),F-G score and acne score were recorded before treatment and at the end of the third and sixth cycle after treatment.Serum total testosterone,follicle stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH,fast plasma glucose,fast insulin and insulin resistance index(HOMA-IR)were obtained at early follicular phase and at the end of the third and sixth month.Results There was no significant change in BMI and WHR after treatment.Compared with those before treatment.F-G score,acne score,serum total testosterone,LH and LH/FSH were significantly decreased at two time points after treatment (P<0.05).BMI and HOMA-IR in patients with insulin resistance were significantly higher at the end of the sixth cycle after treatment than those before treatment(P<0.05). Conclusion Diane-35 can improve hyperandrogenism in non-obese patients with PCOS.However,Diane-35 may aggravate insulin resistance in those with insulin resistance.