Effect of rosiglitazone on spontaneous and clomiphene citrate–induced ovulation in women with polycystic ovary syndrome

Ghazeeri, Ghina; Kutteh, William H.; Bryer‐Ash, Michael; Haas, Derek A; Ke, Raymond W.

doi:10.1016/s0015-0282(02)04843-4

Cited by 167 publications

(93 citation statements)

References 23 publications

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“…Moreover, two rosiglitazone baboons showed luteal phase levels of progesterone. The limited clinical studies on the reproductive influence of rosiglitazone are confined to the polycystic ovary syndrome population and reveal an improved ovulation rate and generous restoration of normal menstrual cycles (53)(54)(55)(56). These references support our observation that there was no untoward endocrinological effect of rosiglitazone versus the placebo group.…”

Section: Discussionsupporting

confidence: 82%

PPAR-gamma receptor ligand induces regression of endometrial explants in baboons: A prospective, randomized, placebo- and drug-controlled study

Lebovic

Mwenda

Chai

et al. 2007

Fertility and Sterility

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Objective-To determine the effects of a thiazolidinedione (TZD) agonist of peroxisome proliferator-activated receptor (PPAR)-γ, rosiglitazone, in a baboon model of established endometriosis.Design-Prospective, randomized, placebo-controlled study.Setting-Experimental surgery laboratory at the Institute of Primate Research in Nairobi, Kenya.Animal(s)-Endometriosis was induced using intrapelvic injection of eutopic menstrual endometrium in 12 female baboons with a normal pelvis that had undergone at least one menstrual cycle since the time of captivity.Intervention(s)-Induction of endometriosis by laparoscopy was performed in 12 baboons with a normal pelvis. Endometrial tissue was extracted from each baboon by curettage and a standard amount of endometrium was then seeded onto several peritoneal sites as previously described. About 34-68 days after the induction of laparoscopy, a pre-treatment laparoscopy (baseline disease assessment) was performed in the baboons to record the extent of endometriotic lesions. The 12 baboons were randomized into 3 groups and treated from the day after the staging laparoscopy for a total duration of 30 days. They received either PBS tablets (n=4, placebo control; placebo tablets once a day by mouth for 30 days), GnRH-antagonists (n=4, active control; Ganirelix acetate 125 μg/day for 30 days) or rosiglitazone (n=4, test drug, 2 mg by mouth each day for 30 days). A 3 rd and final laparoscopy on day 30 after the start of treatment was performed to record the extent of endometriosis. The type of lesion (typical, red, white and suspicious) was recorded. Biopsies were obtained to confirm the histological presence of endometriosis.Main Outcome Measure(s)-A videolaparoscopy was performed 30 days after treatment to document the number and surface area of endometriotic lesions as well as to calculate the revised American Society for Reproductive Medicine score (rAFS) and stage.Corresponding author Dan I. Lebovic, M.D., M.A., Department of Obstetrics and Gynecology, University of Michigan, Tel: 734-615-8257, Fax: 734-647-1006, E-mail: lebovic@umich.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

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Section: Discussionsupporting

confidence: 82%

PPAR-gamma receptor ligand induces regression of endometrial explants in baboons: A prospective, randomized, placebo- and drug-controlled study

Lebovic

Mwenda

Chai

et al. 2007

Fertility and Sterility

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“…Pre-treatment with rosiglitazone 4 mg twice daily was used with placebo or clomiphene on cycle days 5-9 in 25 PCOS patients previously resistant to clomiphene (mean BMI >35 kg/m 2 ). 73 Rosiglitazone alone resulted in ovulation in 33% of subjects versus 77% in the combination group. One patient in the rosiglitazone-only group (8%) and two in the rosiglitazone-clomiphene group (15%) conceived.…”

Section: Thiazolidinediones (Tzds)mentioning

confidence: 96%

“…One patient in the rosiglitazone-only group (8%) and two in the rosiglitazone-clomiphene group (15%) conceived. 73 TZDs are not approved for use in ovulation induction or during pregnancy. They are pregnancy category C.…”

Section: Thiazolidinediones (Tzds)mentioning

confidence: 99%

Polycystic Ovarian Syndrome: Diagnosis and Management

Sheehan¹

2004

Clinical Medicine & Research

207

151

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Polycystic ovarian syndrome (PCOS) affects 4% to 12% of women of reproductive age. The lack of well-defined diagnostic criteria makes identification of this common disease confusing to many clinicians. Also, with the varied manifestations of the disorder a patient may present to any one of several providers: an internist, family practitioner, nurse practitioner, pediatrician, gynecologist, dermatologist, or endocrinologist. Furthermore, the most distressing aspect of PCOS for any given patient may change over time, from hirsutism as a teenager to infertility as a young adult-potentially requiring several different providers along the way. It is important, therefore, that those caring for these patients understand not only the management issues pertinent to their specialty, but also appreciate the other potential health risks in these women. Recent insights into the pathophysiology of PCOS have shown insulin resistance to play a substantial role and as such have brought the long-term issues of type 2 diabetes mellitus and its resultant increased risk of coronary artery disease to the forefront. No longer can irregular menses and/or hirsutism be thought of as benign nuisances. This review will focus on the two most confusing aspects of PCOS for the practicing provider-diagnosis/differential diagnosis and treatment options. Special attention is given to the role of insulin resistance and the potential utility of insulin sensitizers in management. The benefit and utmost importance of lifestyle modification for the long-term health of these women is stressed as well. It is hoped that some clarity in this regard will allow more women to not only be diagnosed and managed properly for their presenting symptoms (hirsutism, irregular menses, etc.), but also to be educated and managed for the continuing health risk of insulin resistance throughout their lives.

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“…In vitro and in vivo studies showed that the sensitivity of insulin to glucose metabolism was subnormal and hyperinsulinaemia in women with PCOS. The administration of insulin sensitizing agents, such as metformin, may increase insulin sensitivity and thus induce ovulation (Nestler et al, 1998;Hasegawa et al, 1999;Vandermolen et al, 2001;Ghazeeri et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Resistin levels of serum and follicular fluid in non-obese patients with polycystic ovary syndrome during IVF cycles

Lu¹,

Huang²,

Li³

et al. 2005

J. Zhejiang Univ. Sci.

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Abstract:Objectives: To measure serum and follicular resistin, steroids hormone levels in women with PCOS (polycystic ovary syndrome) (BMI (body mass index)<25 kg/m 2 ), to assess possible correlations of resistin to hormonal and metabolic parameters and to analyze the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) in women with PCOS and tubal infertility. Study design: We analyzed the clinical outcomes of IVF-ET in women with PCOS (BMI<25 kg/m 2 ) and tubal infertility during the years 2002 to 2004 and compared the serum and follicular fluid resistin levels, estradiol (E 2 ), progesterone (P), testosterone (T) levels in 20 PCOS and 20 healthy, age-matched women without PCOS during IVF-stimulated cycles. The correlations between the resistin levels and the outcomes of IVF-ET were evaluated. Results: No significant differences in resistin levels of either serum or follicular fluid between PCOS and control group were found. However, resistin levels in serum were higher than that in follicular fluid in both groups. Multiple regression analysis showed that resistin levels in serum did not correlate with BMI, estradiol, LH (luteinizing hormone) and insulin level in fasting blood. No significant correlations were found between follicular fluid reisistin levels and fertilization rate, implantation rate, clinical pregnancy rate or early miscarriage rate in both PCOS and control groups. Conclusion: Our results show that resistin does not have correlation with the hormonal and metabolic parameters as well as the outcomes of IVF. These data suggest that resistin is unlikely to be a local determinant factor in steroidogenesis and growth and maturation of oocytes during IVF-ET in lean women with PCOS.

show abstract

Effect of rosiglitazone on spontaneous and clomiphene citrate–induced ovulation in women with polycystic ovary syndrome

Cited by 167 publications

References 23 publications

PPAR-gamma receptor ligand induces regression of endometrial explants in baboons: A prospective, randomized, placebo- and drug-controlled study

PPAR-gamma receptor ligand induces regression of endometrial explants in baboons: A prospective, randomized, placebo- and drug-controlled study

Polycystic Ovarian Syndrome: Diagnosis and Management

Resistin levels of serum and follicular fluid in non-obese patients with polycystic ovary syndrome during IVF cycles

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