A prospective randomized trial comparing the clinical and endocrinological outcome with rosiglitazone versus laparoscopic ovarian drilling in patients with polycystic ovarian disease resistant to ovulation induction with clomiphene citrate.
OBJECTIVE
Rosiglitazone, an insulin sensitizing agent is used currently in women with clomiphene citrate (CC) resistant polycystic ovarian syndrome (PCOS). Our study proposed to compare the efficacy of rosiglitazone and CC with laparoscopic ovarian drilling (LOD) and CC in terms of biochemical effects, ovulation rate and pregnancy rate in patients of PCOS resistant to CC.


METHODS
This prospective randomised trial included 43 patients of PCOS resistant to CC. Twenty-two women were assigned to the rosiglitazone (4 mg twice daily) and CC group and other 21 patients underwent unilateral LOD and then received CC and multivitamins. The treatment continued for six cycles in both the groups. The biochemical response, ovulation rate and pregnancy rate over a follow up period of 6 months were compared.


RESULTS
Treatment with rosiglitazone and CC or LOD and CC resulted in increased ovulation (80.8 vs. 81.5%) and pregnancy (50 vs. 42.8%), respectively. There was no statistical difference between the two groups in terms of biochemical response, ovulation rate and pregnancy rate.


CONCLUSIONS
To avoid the risk of adverse effects of LOD preference may be given to the use of rosiglitazone and CC therapy in patients of PCOS resistant to CC.
Roy
K K
KK
Department of Obstetrics and Gynaecology, Room No. 3085, 3rd Floor, Teaching Block, All India Institute of Medical Sciences, New Delhi, 110029, India. drkkroy2003@gmail.com
Baruah
Jinee
J
Sharma
Aparna
A
Sharma
J B
JB
Kumar
Sunesh
S
Kachava
Garima
G
Karmakar
Debjyoti
D
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004351:Drug Resistance; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D010535:Laparoscopy; D010053:Ovary / Q000601:surgery; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000601:surgery*; D011446:Prospective Studies; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D055815:Young Adult
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D002996:Clomiphene