title: High ovulatory rates with use of troglitazone in clomiphene-resistant women with polycystic ovary syndrome.
abstract: This preliminary report reviews our experience with 18 infertile patients with clomiphene-resistant polycystic ovary syndrome (PCOS). In the first treatment cycle, troglitazone was administered alone. During cycles 2-5, clomiphene was added with increments of 50 mg (up to 200 mg/day) if the previous cycle was anovulatory. Basal body temperature charts and serum progesterone were obtained to confirm ovulation. In a total of 66 treatment cycles, ovulation occurred in 44 (67%) and pregnancy in seven (11%). There were no significant changes in body weight, waist:hip ratio or liver enzymes during treatment. Troglitazone, alone or with clomiphene, induced ovulation in 15 of 18 patients (83%) and seven (39%) of them achieved pregnancy. This is the first report on ovulatory rates in clomiphene-resistant women with PCOS when troglitazone was used alone or with clomiphene. Recently, metformin and clomiphene were successfully used in women with PCOS. However, our patients represent a more resistant population of women with PCOS, with each patient serving as her own historical control by previous resistance to clomiphene. Although the pregnancy rate (39%) was promising for clomiphene-resistant women with polycystic ovary syndrome, it does not seem to have a definite advantage over gonadotrophins.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, School of Medicine, West Virginia University Health Sciences Center, 830 Pennsylvania Avenue, Suite 304, Charleston, WV 25302, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: Mitwally
authors.forename: N K
authors.initials: NK
authors.lastname: Kuscu
authors.forename: T M
authors.initials: TM
authors.lastname: Yalcinkaya
mesh_terms: D000328:Adult; D001831:Body Temperature; D002839:Chromans / Q000008:administration & dosage / Q000627:therapeutic use*; D002996:Clomiphene / Q000008:administration & dosage; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood; D013844:Thiazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D045162:Thiazolidinediones; D000077288:Troglitazone
chemical_list: D002839:Chromans; D013844:Thiazoles; D045162:Thiazolidinediones; D002996:Clomiphene; D011374:Progesterone; D000077288:Troglitazone