Polycystic ovary syndrome. Insulin resistance and ovulatory responses to clomiphene citrate.
OBJECTIVE
To evaluate insulin secretion detected on oral glucose tolerance testing in relation to clomiphene citrate (CC) responses in women with polycystic ovary syndrome (PCOS).


METHODS
A total of 37 PCOS women were enrolled. Plasma baseline levels of gonadotropins, sex hormone binding globulin, androstenedione, dehydroepiandrosterone sulfate and testosterone (T) were determined. Insulin and glucose serum concentrations were analyzed in all samples after a 75-g oral glucose tolerance test. A dose of 100 mg/d of CC was given for ovulation induction. Ovulation was detected by ultrasonographic observation in conjunction with a serum progesterone level.


RESULTS
During three consecutive cycles of CC administration, two or more anovulatory cycles were observed in 12 of 37 PCOS women (defined as CC nonresponders). The serum T level and the area under the curve (AUC) of insulin were significantly higher in CC nonresponders. The receiver operating characteristic curve of the AUC of insulin provided the most appropriate cutoff point for the prediction of CC resistance.


CONCLUSIONS
We found higher androgen secretion and insulin resistance in CC nonresponders. The AUC of insulin was the most reliable method for the prediction of CC resistance associated with insulin resistance.
Murakawa
H
H
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Japan.
Hasegawa
I
I
Kurabayashi
T
T
Tanaka
K
K
D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000187:drug effects; D002996:Clomiphene / Q000494:pharmacology*; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity