Areepan Sophonsritsuk

Efficacy of metformin on ovulation induction in Asian women with polycystic ovary syndrome.

The aim of this study was to assess the efficacy of metformin on induction of ovulation in Asian women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). Twenty PCOS women who did not respond to CC were enrolled in the study. All received 500-1500 mg/day of metformin for 4 weeks. If no dominant follicle was observed with monitoring by transvaginal ultrasound, 50-150 mg of CC per day for 5 days were added. Timing of sexual intercourse was determined or intrauterine insemination was carried out 36 h after administration of human chorionic gonadotropin. A total of six cycles, pregnancy or anovulation despite taking 150 mg of CC were considered as completion of the study. Blood samples were obtained before and at the end of the 4th week of treatment for hormonal assay. Ovulation was observed in 68 (89.5%) of 76 cycles, of which 34 (44.7%) occurred with metformin alone. Twelve women conceived; therefore, the pregnancy rate was 17.6% per ovulated cycle and 60% per woman. One (8.3%) had an abortion. Four women had minimal adverse effect, but one experienced a severe gastrointestinal effect during the fourth cycle. Insulin and androstenedione levels were significantly decreased after 4 weeks of treatment. In conclusion, these series demonstrated the excellent efficacy of metformin on induction of ovulation and pregnancy in Asian women with CC-resistant PCOS.

Comparison of outcomes and direct cost between minimal stimulation and conventional protocols on ovarian stimulation in in vitro fertilization

Aim: To determine whether minimal stimulation with clomiphene and gonadotropin provides outcomes and direct costs comparable with those of a conventional GnRHa‐gonadotropin stimulation protocol for infertile patients undergoing in vitro fertilization.

Randomized controlled trial of different doses of metformin for ovulation induction in infertile women with polycystic ovary syndrome

Aim:  To compare the efficacy of 1000 mg and 1700 mg of metformin on ovulation induction in polycystic ovary syndrome (PCOS) women.

Prevalence of polycystic ovary syndrome in Thai University adolescents

Abstract Polycystic ovarian syndrome (PCOS) is a common and complex condition characterized by endocrine features and influenced by genetic and environmental factors. In Southeast Asia and Thailand, the prevalence of PCOS is unknown. The aim of this study was to estimate the prevalence of and determine factors associated with PCOS in Thai adolescents. We administered a validated questionnaire to 600 university female participants aged 17–19 years from Mahidol University in Bangkok. Of these, 548 (91.33%) responded and agreed to participate. Two-hundred and seventy-nine girls (50.91%) were identified as likely having PCOS and defined as ‘probable cases’. Of those 279 participants, 248 (88.88%) were evaluated further for PCOS using the Rotterdam criteria. A complete history was taken, and a physical examination including trans-abdominal ultrasound was performed. Blood chemistry tests were performed to exclude similar conditions and to investigate potential co-morbidities. The prevalence of PCOS in Thai adolescents was found to be 5.29%. After multivariate analyses, moderate acne was the strongest risk factor for PCOS. The odd ratios (95% confidence interval) for the presence of mild acne, moderate acne, and oligo- or amenorrhea in participants with PCOS were 2.83 (1.01–7.90; p = .47), 31.69 (10.07–99.67; p < .001), and 5.89 (2.42–14.37; p < .001), respectively.