A LONG-TERM TREATMENT WITH GONADOTROPIN-RELEASING-HORMONE AGONIST PLUS A LOW-DOSE ORAL-CONTRACEPTIVE IMPROVES THE RECOVERY OF THE OVULATORYFUNCTION IN PATIENTS WITH POLYCYSTIC-OVARY-SYNDROME

Objective: To evaluate the hormonal and clinical follow-up after the s uspension of a longterm therapy with GnRH-agonist (GnRH-a) plus oral c ontraceptive (OC) in comparison to OC alone in patients with polycysti c ovary syndrome (PCOS).Design: Hormonal (plasma LH, FSH, sex steroid levels) and clinical (Ferriman-Gallwey score and ultrasound) parameter s were monitored at various moments during the 6 months of treatment a nd during the 6 months after treatment suspension. Setting: Physiopath ology of Human Reproduction, University of Modena, Italy. Patient(s): Thirty patients with PCOS were enrolled and randomly subdivided in two groups of 15 each. Intervention(s): Group A was treated with 3.75 mg IM GnRH-a plus OC. Group B was treated only with OC. Result(s): Both t herapeutical regimens were effective in reducing androgenic milieu, Fe rriman-Gallwey score, and ovarian volume within the 6th month of treat ment. However, only patients treated with GnRH-a + OC showed a normal LH:FSH ratio, adequate plasma Ep and P levels, and ovulatory cycles du ring the 6 months of the after treatment follow-up. Patients treated w ith OC alone showed no beneficial effect after the 3rd month of the fo llow-up. Conclusion(s): These data support the evidence of a higher ef ficacy of the combined regimen (GnRH-a + OC) than OC alone in the trea tment of patients with PCOS. In addition, the former regimen is associ ated with recovery of normal ovulatory cycles.