Combination of pioglitazone and clomiphene citrate versus clomiphene citrate alone for infertile women with the polycystic ovarian syndrome

Abstract

Background Anovulation is one of the common causes of infertility. Polycystic ovary syndrome (PCOS) is the most common disorder with chronic Anovulation. To the best of our knowledge, insulin resistance relates significantly to PCOS. Therefore administration of insulin-sensitizing drugs such as pioglitazone can be used for ovulation stimulation in PCO patients. Methods After obtaining approval from the Ethics Committee of Mashhad University of Medical Sciences, 61 patients with PCOS were enrolled in the study based on inclusion/ exclusion criteria. Patients were divided into two groups. The first group received 30 mg (mg) of pioglitazone daily from the second day of the menstrual period. The second one received a placebo. 150 mg clomiphene citrate was administered from the third to the seventh day of the menstrual cycle. Vaginal sonography was performed in all women, and in cases with the mature follicle, intrauterine insemination was conducted after human chorionic gonadotropin injection. Ovary stimulation and pregnancy rate were compared between groups. Results There were no differences between groups regard to demographic characteristics and infertility type. Body mass index was higher in the pioglitazone group (28.3 ± 3.8 versus 26.2 ± 3.5, P value = 0.047). The size of the follicle was not significantly different between groups (2.2 ± 1.4 versus 1.3 ± 1.1, P value = 0.742). pregnancy rate [4 (12.9%) versus 4 (13.3%), P value = 1] had no differences between groups. Conclusion Although the number of follicles was higher in the pioglitazone group, our study showed no differences in ovary stimulation and pregnancy rate.

Fertility-enhancing effect of oil-based contrast agents during hysterosalpingography and the variation of this effect within a 3-year follow-up period in infertile patients

“…(2) Other post-HSG fertility-enhancing treatments (such as ovulation stimulation and traditional Chinese medicine) might also affect the spontaneous pregnancy rate. Therefore, the influence of spontaneous pregnancy rate by oil-based contrast agents was attenuated (23)(24)(25)(26).…”

A randomized controlled trial comparing pioglitazone and metformin prior to in vitro fertilization in polycystic ovary syndrome – associated infertile women: impact on pregnancy rates

“…In our study, the number of embryos implantations and oocytes were not significantly different in pioglitazone and metformin groups, respectively. Nonetheless, the pioglitazone group demonstrated a notably higher count of successful pregnancies 19 . They conducted a comparative analysis of the impacts of clomiphene citrate, metformin, and pioglitazone in clomiphene citrate-resistant-PCOS women and assessed their effects on IVF outcomes.…”

Rescuing fertility during COVID-19 infection: exploring potential pharmacological and natural therapeutic approaches for comorbidity, by focusing on NLRP3 inflammasome mechanism.

“…Interestingly, there are NLRP3 inhibitors with multiple functions that improve some infertility pathology. Pioglitazone, an insulin sensitizer, is used to promote ovulation in PCOS patients with insulin resistance; on the other hand, it is a potent NLRP3 inhibitor and exerts an anti-inflammatory effect, declining NLRP3 levels and downstream inflammatory cytokines in patients with diabetes mellitus [168,169]. MCC950 and CY-09 were used to attenuate dysmenorrhea and reduce the development of endometriotic lesions by suppressing the NLRP3, respectively [170,171].…”