Serum resistin as a predictor of ovarian response to clomiphene therapy in PCOS infertile patients

ABSTRACT

To measure serum resistin levels on day 3-6 of the menstrual cycle of infertile women with Polycystic ovary syndrome [PCOS] undergoing induction of ovulation using clomiphene citrate [CC] to ascertain whether these levels could allow us to predict the ovarian response to CC in those patients. 40 women with the diagnosis of infertility due to polycystic ovary syndrome [PCOS], were included in the study. Participants were included after fulfilling the Rotterdam criteria, 2004. All included participants were investigated by measuring body mass index [BMI], serum follicle stimulating hormone [FSH], serum luteinizing hormone [LH], serum fasting glucose, serum fasting insulin, fasting glucose-to-insulin ratio and serum resistin levels. Participants were treated with clomiphene citrate protocol to induce ovulation. Clomiphene was started as 100mg/day [2 tablets of 50mg] at day 2 for 5 consecutive days for 3 cycles. Ovulation was assessed by midluteal serum progesterone measurement combined with transvaginal sonographic monitoring of follicle growth until the appearance of a preo-vulatory follicle [mean diameter, >/= 18mm] and subsequent follicle rupture. According to the final ovarian response [which is the primary outcome], the study participants were divided into proper response group [ovulation has occurred at least once under treatment during the treatment period] and poor response group [ovulation has never occurred during the 3 study cycles]. Serum resistin was compared between the 2 outcome groups to test its relation to ovarian response. No significant correlation was found between the 2 outcome groups [proper and poor responders] regarding body mass index [BMI], 28.76 +/- 4.86, 29.13 +/- 5.09 respectively, p=0.817. Similarly no statistically significant difference was found between the 2 outcome groups regarding serum LH, FSH, total testosterone levels [p=0.437, 0.327, 0.672 respectively]. Serum fasting glucose, fasting insulin, fasting glucose-to-insulin ratio were not statistically significant when compared between the outcome groups [p=0.456, 0.108, 0.191 respectively]. Serum resistin levels in women who succeeded to ovulate and those who failed to ovulate under clomiphene therapy were not statistically significant when compared between both groups [22.16 +/- 21.6, 24.37 +/- 22.9, respectively, p=0.757]. However, serum resistin levels were positively correlated to serum total testosterone, fasting serum glucose and insulin levels [p=0.008, 0.024, 0.011 respectively]. Serum resistin is likely not a predictor for ovarian response in infertile women with PCOS undergoing induction of ovulation using CC