RÉSUMÉ
Background: PCOS is a common endocrine disorder in women of reproductive age. Letrozole is an orally active aromatase inhibitor and as effective as chlomiphene citrate for induction of ovulation. Estrogen is important in the regeneration and growth of the endometrium prior to ovulation prepare the tissue to respond to progesterone post ovulation in PCOS patients. Aim of the study was to assess the effects of estradiol valerate on endometrial thickness in PCOS having ovulation induction with letrozole.Methods: This randomized controlled study was conducted in the department of reproductive endocrinology and infertility, BSMMU, Dhaka, with 1 year duration. A total 80 diagnosed cases of PCOS patients with subfertility were included in this study. Among them 40 patients received letrozole and estradiol valerate and 40 patients received letrozole and placebo.Results: On day 8, mean endometrial thickness was not statistically significant between two groups (p=0.436). On day of triggering, mean endometrial thickness was significantly higher in intervention group 9.2±1.4 mm than control group 8.2±1.4 mm (p=0.004). Mean changes of endometrial thickness on day of triggering compared with on day 8 was significantly higher in intervention group 3.2±1.5 mm than control group 2.5±1.6 mm (p=0.043). Pregnancy rate was higher in intervention group 13 (38.2%) than control group 8 (22.2%) with relative risk 1.72, 95% CI (0.82-3.63%), that was not statistically significant between two groups (p=0.144).Conclusions: Mean changes of endometrial thickness on day of triggering were significantly higher in intervention group than control group. The pregnancy rate achieved with letrozole+estradiol valerate combination was higher than that achieved with letrozole and placebo group.
RÉSUMÉ
Background: PCOS is a common endocrine disorder in women of reproductive age. Letrozole is an orally active aromatase inhibitor and as effective as chlomiphene citrate for induction of ovulation. Estrogen is important in the regeneration and growth of the endometrium prior to ovulation prepare the tissue to respond to progesterone post ovulation in PCOS patients. Aim of the study was to assess the effects of estradiol valerate on endometrial thickness in PCOS having ovulation induction with letrozole.Methods: This randomized controlled study was conducted in the department of reproductive endocrinology and infertility, BSMMU, Dhaka, with 1 year duration. A total 80 diagnosed cases of PCOS patients with subfertility were included in this study. Among them 40 patients received letrozole and estradiol valerate and 40 patients received letrozole and placebo.Results: On day 8, mean endometrial thickness was not statistically significant between two groups (p=0.436). On day of triggering, mean endometrial thickness was significantly higher in intervention group 9.2±1.4 mm than control group 8.2±1.4 mm (p=0.004). Mean changes of endometrial thickness on day of triggering compared with on day 8 was significantly higher in intervention group 3.2±1.5 mm than control group 2.5±1.6 mm (p=0.043). Pregnancy rate was higher in intervention group 13 (38.2%) than control group 8 (22.2%) with relative risk 1.72, 95% CI (0.82-3.63%), that was not statistically significant between two groups (p=0.144).Conclusions: Mean changes of endometrial thickness on day of triggering were significantly higher in intervention group than control group. The pregnancy rate achieved with letrozole+estradiol valerate combination was higher than that achieved with letrozole and placebo group.
RÉSUMÉ
Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age, characterized by hormonal imbalance and insulin resistance. D-chiro-inositol, a naturally occurring inositol isomer, has been suggested as a potential treatment option for PCOS. This study aimed to investigate the effects of D-chiro-inositol supplementation on hormonal parameters, and insulin resistance in women with PCOS.Methods: This randomized controlled study was conducted among 60 women of PCOS with insulin resistance, who were assigned to either Group A (D-chiro-inositol) or Group B (placebo) for 12 weeks. S. FSH, LH, S. total testosterone, fasting blood glucose, fasting insulin, and insulin resistance (HOMA-IR) were measured at baseline and after 12 weeks of treatment. Statistical analyses were performed using SPSS version 23.0 for Windows.Results: After 12 weeks of treatment, significant reductions in serum luteinizing hormone, serum total testosterone, fasting insulin, and HOMA-IR were observed in the D-chiro-inositol group compared to the placebo group. However, no significant changes were observed in fasting blood glucose levels. D-chiro-inositol was well-tolerated, with no significant differences in side effects between the two groups.Conclusions: D-chiro-inositol supplementation for 12 weeks significantly improved hormonal parameters, and insulin resistance in women with PCOS. The treatment was well-tolerated, suggesting that D-chiro-inositol can be an effective therapeutic option for patients with PCOS.
RÉSUMÉ
Background: Quality of life (QoL) is lower in infertile women. Fertility expectations are as variable as social norms and culture and so is QoL. We expect to explore the QoL of infertile couple in a traditional society like that of Bangladesh.Methods: We measured the quality of the life of 88 infertile women attending the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University, with WHOQOL-BREF questionnaire, covering physical, psychological, social and environmental domains. The scores were calculated in the range of 4-20 and 0-100.Results: When we calculated in the range of 0-100, infertile women had mean score of 61.12 in physical, 54.78 in psychological, 70.36 in social and 58.63 in environmental domains. Nearly half (41.7%) of the women scored at or below 50 in psychological domain compared to 26% in physical, 14.6% in social and 28.1% in environmental domain.Conclusions: The QoL of infertile women as measured by WHOQOL-BREF has moderate scores. The women are disadvantaged in psychological domain compared to physical, social or environmental aspects. So, they need more psychological support during treatment.