A long-term treatment with gonadotropin-releasing hormone agonist plus a low-dose oral contraceptive improves the recovery of the ovulatory function in patients with polycystic ovary syndrome.
OBJECTIVE
To evaluate the hormonal and clinical follow-up after the suspension of a longterm therapy with GnRH-agonist (GnRH-a) plus oral contraceptive (OC) in comparison to OC alone in patients with polycystic ovary syndrome (PCOS).


METHODS
Hormonal (plasma LH, FSH, sex steroid levels) and clinical (Ferriman-Gallwey score and ultrasound) parameters were monitored at various moments during the 6 months of treatment and during the 6 months after treatment suspension.


METHODS
Physiopathology of Human Reproduction, University of Modena, Italy.


METHODS
Thirty patients with PCOS were enrolled and randomly subdivided in two groups of 15 each.


METHODS
Group A was treated with 3.75 mg IM GnRH-a plus OC. Group B was treated only with OC.


RESULTS
Both therapeutical regimens were effective in reducing androgenic milieu, Ferriman-Gallwey score, and ovarian volume within the 6th month of treatment. However, only patients treated with GnRH-a + OC showed a normal LH:FSH ratio, adequate plasma E2 and P levels, and ovulatory cycles during the 6 months of the after treatment follow-up. Patients treated with OC alone showed no beneficial effect after the 3rd month of the follow-up.


CONCLUSIONS
These data support the evidence of a higher efficacy of the combined regimen (GnRH-a + OC) than OC alone in the treatment of patients with PCOS. In addition, the former regimen is associated with recovery of normal ovulatory cycles.
Genazzani
A D
AD
University of Modena, Italy. algen@unimo.it
Petraglia
F
F
Battaglia
C
C
Gamba
O
O
Volpe
A
A
Genazzani
A R
AR
D000728:Androgens / Q000097:blood; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood; D008186:Luteolytic Agents / Q000627:therapeutic use*; D008597:Menstrual Cycle; D010053:Ovary / Q000000981:diagnostic imaging; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011374:Progesterone / Q000097:blood; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D014463:Ultrasonography
D000728:Androgens; D003276:Contraceptives, Oral; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide