Rosiglitazone as treatment for clomiphene citrate-resistant polycystic ovary syndrome: factors associated with clinical response.
OBJECTIVE
To identify the various clinical, biochemical, and ultrasonographic factors that determine clinical response to rosiglitazone as a first-line therapy in a series of women with newly diagnosed clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS).


METHODS
This retrospective analysis included 200 women with newly diagnosed CC-resistant PCOS who received rosiglitazone as a first-line therapy between 2001 and 2006. The effect of clinical and biochemical characteristics on the ovulation and pregnancy rates during rosiglitazone therapy was evaluated. Women were divided into three categories according to the severity of clinical and biochemical parameters of PCOS. The success rates were compared among the categories using contingency table analysis. Multiple regression analysis was used to identify independent predictors of success of rosiglitazone therapy.


RESULTS
Body mass index (BMI) > or = 35 kg/m(2), serum testosterone concentration > or = 4.5 nmol/L, free androgen index (FAI) > or = 15, and with duration of infertility > 3 years were associated with poor response to rosiglitazone therapy. In rosiglitazone responders, women with lower pretreatment serum luteinizing hormone (LH) concentrations or a lower LH/follicle-stimulating hormone (FSH) ratio are more likely to have a sustained beneficial effect.


CONCLUSIONS
Marked obesity, marked hyperandrogenism, and long duration of infertility in women with newly diagnosed CC-resistant PCOS were predictors of resistance to rosiglitazone therapy as a first-line treatment.
Shokeir
Tarek
T
Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. tarekshokeir@hotmail.com
El-Kannishy
Ghada
G
D000328:Adult; D000858:Anovulation / Q000000981:diagnostic imaging / Q000188:drug therapy; D015992:Body Mass Index; D002996:Clomiphene / Q000494:pharmacology*; D004351:Drug Resistance; D004534:Egypt; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D000077154:Rosiglitazone; D020845:Selective Estrogen Receptor Modulators / Q000494:pharmacology*; D013739:Testosterone / Q000097:blood; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014463:Ultrasonography; D055815:Young Adult
D007004:Hypoglycemic Agents; D020845:Selective Estrogen Receptor Modulators; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D002996:Clomiphene; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone