COMBINED SOMATOSTATIN ANALOG AND FOLLICLE-STIMULATING-HORMONE FOR WOMEN WITH POLYCYSTIC-OVARY-SYNDROME RESISTANT TO CONVENTIONAL TREATMENT

This study was undertaken to determine whether somatostatin analog in combination with human urinary follicle-stimulating hormone (FSH) impr oves ovulatory performance in patients with polycystic ovarian syndrom e (PCOS) who failed to respond to FSH alone. A comparative prospective study was performed in six insulin-resistant, hyperandrogenic, PCOS w omen created with somatostatin analog combined with FSH for one cycle. Individual ovulatory performance was compared to the cumulative ovula tory response of three previous cycles. Somatostatin analog was admini stered subcutaneously by means of an infusion pump, providing a total daily dose of 200 mu g starting from days 1-3 of the cycle. Induction of ovulation with FSH was initiated on day 5 of the stimulated cycle. Vaginal ultrasonography for follicular surveillance was performed befo re the pump setting and during the treatment cycle. A significant decr ease in insulin, insulin-like growth factor (IGF-I), growth hormone (G H) and luteinizing hormone (LH) was observed during the combined somat ostatin analog-FSH treatment cycles. The follicular growth patterns an d the incidence of ovarian hyperstimulation syndrome (OHSS) was not af fected. These observations suggest that adjuvant therapy with somatost atin analog may have a beneficial effect on the hormonal response of P COS patients to gonadotropin induction of ovulation.