ABSTRACT
OBJECTIVE: To determine the clinical, endocrine, and metabolic effects of acarbose use in overweight and nonoverweight patients with polycystic ovarian syndrome (PCOS). DESIGN: Prospective analysis. SETTING: Gynecology and infertility clinic of a tertiary care medical center. PATIENT(S): Seventy-four patients with PCOS and 30 healthy women. INTERVENTION(S): Acarbose use. MAIN OUTCOME MEASURE(S): Clinical findings of hyperandrogenism, body mass indices, LH, FSH, DHEAS, total T, PRL, basal insulin, fasting glucose/insulin levels, and lipid profiles. RESULT(S): Acarbose treatment improved LH/FSH levels, decreased total T, DHEAS, basal insulin, low-density lipoprotein, very low-density lipoprotein, and triglyceride levels, and increased high-density lipoprotein levels in patients with PCOS. Basal insulin and fasting glucose/insulin levels reacted more significantly in overweight patients undergoing acarbose treatment. CONCLUSION(S): Acarbose has been found to improve insulin levels and thus glucose/insulin ratios more effectively in overweight patients compared with nonoverweight patients with PCOS. This drug seems to be an effective drug to be used in overweight as well as nonoverweight patients with PCOS.
Subject(s)
Acarbose/therapeutic use , Glycoside Hydrolase Inhibitors , Insulin/blood , Obesity/diagnosis , Obesity/drug therapy , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/drug therapy , Adult , Female , Humans , Hypoglycemic Agents/therapeutic use , Obesity/blood , Polycystic Ovary Syndrome/blood , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the predictive value of antimüllerian hormone (AMH) as a marker for ovarian reserve and to compare its value with the markers currently being used. DESIGN: Prospective analysis. SETTING: In vitro fertilization (IVF) clinic of a tertiary medical center. PATIENT(S): Fifty women undergoing assisted reproduction cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Comparison of day-3 serum AMH levels among women with less than five retrieved oocytes and five or more oocytes. Antral follicle count, mature oocyte count, age, basal follicle-stimulating hormone (FSH), estradiol (E2), maximum serum E2 levels, and pregnancy success were also compared. RESULT(S): The mean serum AMH levels of patients with more than five retrieved oocytes were found to be higher (0.67 +/- 0.41 vs. 0.15 +/- 0.11 pg/mL). Mature oocyte counts, antral follicle counts, and maximum E2 levels were found to be statistically significantly different in the two groups despite similar ages and levels of basal FSH and E2. Although the receiver operator characteristics analysis revealed that the most sensitive and specific indicator of ovarian reserve is the level of AMH, it does not indicate pregnancy success as well when 0.25 pg/mL is taken as a cut-off value. CONCLUSION(S): These data demonstrate an association between early follicular serum AMH and ovarian response, but no association with pregnancy success.
