Fuente-Valero J, Zapardiel-Gutiérrez I, Orensanz-Fernández I, Álvarez-Álvarez P, Engels-Calvo V, Bajo-Arenas JM

Language: Spanish
References: 14
Page: 58-64
PDF size: 398.19 Kb.

ABSTRACT

Objective: To measure the vascularization and ovarian volume with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome with stimulated ovulation treatment, and to analyse the differences between the patients treated with clomiphen citrate versus clomiphen citrate and metformin.
Material and method: Therty patients were studied. Twenty ovulation cycles were obtained with clomiphen citrate and 17 with clomiphen citrate plus merformin (added in case of obesity or hyperglucemy/hyperinsulinemia). Ovarian volumes and vascular indexes were studied with 3D-sonography and results were analysed by treatment.
Results: There were no statistical differences of ovarian volume by treatment along the cycles, although bigger volume were found in ovulatory cycles compared to non-ovulatory ones (20,36 versus 13,89 ml, p = 0,026). No statistical differences were also found concerning vascular indexes, neither by treatment nor by the obtention of ovulation in the cycle.
Conclusions: Ovarian volume and vascular indexes measured with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome do not show differents values in patients treated with clomiphen citrate alone versus clomiphen citrate plus metformin.

REFERENCES

1. Homburg R. Polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2008;22(2):261-274.

2. Homburg R. The management of infertility associated with polycystic ovary syndrome. Reprod Biol Endocrinol 2003;1(1):109.

3. Costello MF, Eden JA. A systematic review of the reproductive system effects of metformin in patients with polycystic ovary syndrome. Fertil Steril 2003; 79(1):1-13.

4. Kashyap S, Wells GA, Rosenwaks Z. Insulin-sensitizing agents as primary therapy for patients with polycystic ovarian syndrome. Hum Reprod 2004; 19(11):2474-2483.

5. Speroff L, Fritz MA. Endocrinología ginecológica clínica y esterilidad. 2ª ed. Madrid: Wolters kluwer Health España S.A., 2006.

6. The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-47.

7. Nasseri S, Ledger WL. Clomiphene Citrate in the twenty-first century. Human Fertil (Camb) 2001;4:145-151.

8. Rossing MA, Daling JR, Weiss NS, Moore DE, et al. Ovarian tumors in a cohort of infertile women. N Engl J Med 1994;331(12):771-776.

9. Lord JM, Flight IH, Norman RJ. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ 2003;327(7421):951-953.

10. Amer A, Hammadeh ME, Kolkailah M, Ghandour AA. Threedimensional versus two-dimensional ultrasound measurement of follicular volume: are they comparable? Arch Gynecol Obstet 2003;268(3):155-157.

11. Mercé LT, Gómez B, Engels V, Bu S, et al. Intra and interobserver reproducibility of ovarian volume, antral follicle count and vascularity indices obtained with transvaginal 3-dimensioal ultrasonography, power Doppler angiography and Virtual Organ Computer-Aided image program. Journal of Ultrasound Medicine 2005;24:1279-1287.

12. Allemand MC, Tummon IS, Phy JL, Foong SC, et al. Diagnosis of polycystic ovaries by three-dimensional transvaginal ultrasound. Fertil Steril 2006;85(1): 214-219.

13. Alcázar JL, Mercé LT, Sabatel R, Troyano JM. Ecografía y angiografía power Doppler tridimensional del ovario normal y patológico. En: Mercé Alberto LT. Teoría y práctica de la ecografía y angiografía Doppler tridimensional en Obstetricia y Ginecología. Madrid: Habe, 2006.

14. Jokubkiene L, Sladkevicius P, Rovas L, Valentin L. Assessment of changes in volume and vascularity of the ovaries during the normal menstrual cycle using three-dimensional power Doppler ultrasound. Hum Reprod 2006;21(10):2661-2668.