ECE2010 Poster Presentations Female reproduction (44 abstracts)
1Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University Federico II of Naples, Naples, Italy; 3Department of Molecular and Clinical Endocrinology and Oncology, University Federico II of Naples, Naples, Italy; 4Endocrinology, Faculty of Exercise Sciences, University Parthenope of Naples, Naples, Italy.
Clomiphene citrate (CC) is the first-line therapy for inducing ovulation in infertile women with polycystic ovary syndrome (PCOS), but about 20% of them results un-responsive. Lifestyle modification programs are effective in restoring ovarian function and improving reproductive outcomes in PCOS patients.
The aim of the present randomized controlled trial was to test the hypothesis that a very short-term intervention consisting in structured exercise training (SET) plus hypocaloric diet improves ovarian response to CC in CC-resistant PCOS patients.
Ninety-six infertile CC-resistant PCOS patients were investigated.
SET plus hypocaloric diet for 6 weeks (group A), 2 weeks of observation followed by one-cycle of CC therapy (group B), and SET plus hypocaloric diet for six weeks plus one-cycle of CC added after the first two weeks (group C).
After intervention, the ovulation rate was significantly (P<0.05) higher in group C in comparison with groups A and B (12/32 (37.5%), 4/32 (12.5%) and 3/32 (9.4%) for group C, A and B, respectively). Compared to baseline, in both group A and C, a significant improvement in clinical and biochemical androgen and insulin sensitivity indexes was observed. In the same two groups, insulin sensitivity indexes were significantly (P<0.05) better than group B.
In conclusion, in CC-resistant PCOS patients, a very short-term intervention consisting of SET plus hypocaloric diet is effective at improving ovarian sensitivity to CC by an acute and body weight independent effect on androgens and insulin resistance.