Effects of pioglitazone on ovarian stromal blood flow, ovarian stimulation, and in vitro fertilization outcome in patients with polycystic ovary syndrome.
OBJECTIVE
To investigate the effects of pioglitazone on ovarian stimulation, in vitro fertilization (IVF) outcome, and intraovarian stromal blood flow in patients with polycystic ovary syndrome (PCOS).


METHODS
Prospective, randomized, controlled trial.


METHODS
University-affiliated infertility clinic.


METHODS
Sixty infertile patients with PCOS resistant to clomiphene citrate.


METHODS
An IVF protocol involving use of a gonadotropin-releasing hormone (GnRH) antagonist and oral contraceptive pretreatment. Patients were randomized into two groups: pioglitazone (30 mg daily) in the study group or placebo in the control group, commenced on the day on which oral contraceptive intake began.


METHODS
Ovarian stimulation, IVF outcome, and resistance index of the intraovarian stromal artery.


RESULTS
The resistance index value on the day of human chorionic gonadotropin (hCG) injection in the study group was statistically significantly higher in the study group than in controls. The serum estradiol level and number of retrieved oocytes were statistically significantly lower in women treated with pioglitazone. However, the number of mature oocytes and fertilized oocytes, and the clinical pregnancy rate were similar in both groups.


CONCLUSIONS
Pioglitazone therapy reduced intraovarian stromal blood flow and might be beneficial in improving both the response to ovarian stimulation and IVF outcome in PCOS patients.
Kim
Chung-Hoon
CH
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea. chnkim@amc.seoul.kr
Jeon
Gyun-Ho
GH
Kim
So-Ra
SR
Kim
Sung-Hoon
SH
Chae
Hee-Dong
HD
Kang
Byung-Moon
BM