THE IMPACT OF INSULIN-RESISTANCE ON THE OUTCOME OF OVULATION INDUCTION WITH LOW-DOSE FOLLICLE-STIMULATING-HORMONE IN WOMEN WITH POLYCYSTIC-OVARY-SYNDROME

In this study we examined the possible correlation between insulin met abolism and outcome of gonadotrophin stimulation in infertile clomiphe ne citrate resistant women with polycystic ovary syndrome (PCOS), The patient group comprised 42 women who were entered into the study in a consecutive fashion. Following performance of the CIGMA (continuous in fusion of glucose with model assessment) test, 17 women were classifie d as insulin resistant and 25 women as non-insulin resistant. Each wom an received up to two cycles of low-dose follicle stimulating hormone (FSH) stimulation starting with 75 IU of FSH for 1 week, giving a tota l of 70 cycles performed. The insulin resistant PCOS women required mo re gonadotrophin and a longer time to achieve follicular maturation. B y multiple regression gonadotrophin consumption correlated best with C IGMA value but not with fasting insulin concentration or body mass ind ex. In the insulin resistant PCOS women 10 out of 29 cycles were cance lled due to a multifollicular response, while only one of 41 cycles wa s cancelled in the noninsulin resistant PCOS women. Although ovulation rate in completed cycles was similar between the groups, the concepti on rate was significantly better in the non-insulin resistant PCOS wom en. In conclusion, in PCOS women insulin resistance seems to be an unf avourable condition resulting in an elevated cancellation rate and a l ow conception rate following low-dose FSH stimulation.