|Comparison of Naltroxene and Metformin Pretreatment for Induction of Ovulation in The Patients With Polycystic Ovary Syndrome in IUI Cycles|
|Afsun Zarei1, Bahia Namavar Jahromi1, Gooya Madadi1, Mahshid Alborzi1, Pardis Bakhshaei 1|
|1Infertility research center ,department of OB&GYN, Shiraz university of medical sciences ,Shiraz. Iran|
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Keywords : IUI, Metformin, Nalteroxane,PCOs
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Objective: Polycystic ovary syndrome (PCOs) is a common endocrine disorder among women. Hyperinsulinemia and insulin resistance are seen in PCOs patients and metformin is used to treat the disease. There is evidence that the opioid system plays a role in the pathogenesis of PCOS. In this study, the role of opioid antagonist (naltrexone) in comparison with metformin was evaluated in PCOs-induced infertility.
Materials and Methods: Three groups of 40 patients are assigned to each of the three groups according to Rotterdam diagnostic criteria with a Body Mass Index (BMI) of 25-30 kg/m2 afflicted with PCOs. To the naltrexone group 50 mg / day for 8 weeks and to the other group of metformin 1000 mg / day for the first week and then 1500 mg for seven weeks, and the third group will enter the intrauterine insemination (IUI) without any prior therapeutic treatment, The three groups will be compared in terms of the amount of estradiol produced per day of human chorionic gonadotropin (hCG) injection and the total amount of gonadotropin needed, the number and size of adult follicles, the number of days of taking the drug, and the incidence of pregnancy-induced abortion.
Result: Mean infertility duration time in 3 groups was not significant(p- value = 0.782). Mean fasting insulin level between Metformin and control group show significantly difference (p = 0.045). The average number of days to trigger patients in 3 group wasn’t significant(p = 0.346). The average number of follicles between metformin and naltrexone groups was not significant but was higher in naltrexone group compare to metformin group. The average body mass index (BMI) of naltrexone group after treatment was lower than before treatment (p ≤ 0.001).
Conclusion: The number of receiving days and the dose of the drug in the naltrexone group is lower than the metformin group, and the number of Mature follicles in both ovaries and the serum estradiol level in the naltrexone group is higher than the metformin group
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