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PCOS 2018
Journal of Clinical and Molecular Endocrinology
ISSN: 2572-5432
Page 48
June 07-08, 2018
London, UK
4
th
World Congress on
Polycystic Ovarian
Syndrome
Background & Objectives:
PCOS is the most common cause of
anovulatory infertility. Up to 64% of women with mild HP fulfill
modified Rotterdam diagnostic criteria for PCOS. HP affects
hypothalamic-pituitary-ovarian axis causing anovulation. CE,
a dopamine receptor agonist, inhibits prolactin secretion and
can lead to better ovulatory response in those patients. LE, an
aromatase inhibitor, without adverse effects on endometrium,
induces fewer mature follicles with less risk of ovarian
hyperstimulation syndrome (OHSS). Our study aim was to
investigate effects of combined LE and CE in comparison to LE
alone on ovulation and clinical pregnancy rates in PCOS patients
with HP.
Methods:
A total of one eighty women with PCOS were enrolled
in a hospital based clinical trial and randomly allocated into two
groups (A and B). Participants were in the age group of 22–38
years, all with a serum prolactin >32 ng/ml. Patients in A group
(92) were given LE, 5 mg from day cycle 3–7/3 cycles in addition
to CE, 0.5mg weekly for 12 weeks. Those in group B (88) received
only LE; same dose and duration. All patients were matched for
their age and body mass index. Exclusion criteria: other causes of
HP. Main outcome measure was rate of ovulation and detection
of both chemical and clinical pregnancies by estimation of βhCG
and ultrasound detection of fetal cardiac activity, 2–4 weeks after
missed period. Follow-up period was for six months. Statistical
analysis of data was performed using SPSS version for windows.
P-value was considered significant if <0.05.
Results:
Three patients from group A and five from group B had
drug side effects and were excluded from the study. None of the
patients in either group were lost during the follow-up period. In
group A, difference between mean serum level of prolactin before
and after treatment was statistically significant (P<0.001): 48±3
ng/ml and 9.7±4.5 ng/ml, respectively. No significant decrease
was observed in prolactin level in group B. Ovulation rate was
higher in group A (64.8%) in comparison to group B (41.2%),
(P<0.001). Clinical pregnancy rate was (40.8%) in group A and
(27.3%) in group B (P<0.001). Neither twin pregnancy, nor OHSS
were recorded in both groups.
Conclusions:
The combination of LE andCE is superior to LE alone
in management of anovulatory patients with PCOS and should be
used as the first-line treatment for them.
elbaregsm@hotmail.comEfficacy of letrozole (LE) combined with cabergoline (CE)
in comparison to LE alone in ovulation induction among
patients with polycystic ovarian syndrome (PCOS) and
hyperprolactinemia (HP)
Aisha Elbareg
Misurata University, Libya
J Clin Mol Endocrinol 2018, Volume 3
DOI: 10.21767/2572-5432-C1-003