Majalah Obstetri & Ginekologi
ISSN 0854-0381
Vol. 21 / No. 3 / Published : 2013-09
Order : 2, and page :94 - 99
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Original Article :
Comparison of homa-ir, uterine and spiral artery resistance and endometrium in pcos patient with clomiphen citrate and naltrexone treatment
Author :
- Akhmad Khof Albar*1
- Budi Santoso*2
- Agus Sulistyono*3
- Samsulhadi*4
- Mahasiswa Fakultas Kedokteran
- Dosen Fakultas Kedokteran
- Dosen Fakultas Kedokteran
- Dosen Fakultas Kedokteran
Abstract :
Clomiphene citrate become the first-line treatment in ovulatory PCOS patients, but only for ovulation induction. Naltrexone canrestore menstrual regularity, induce ovulation, and reduce LH/FSH ratio, and testosterone levels. This study was to compareHOMA-IR, uterine and spiral artery resistance, endometrium thickness and trilaminar pattern after naltrexone or clomiphene citrateadministration in PCOS patients.This study used pre dan post test control group design in PCOS patients according to Rotterdamcriteria. Population was divided into two groups, one receiving naltrexon for 5 days in 50 mg/day, 100 mg/day,and 150 mg/day forfirst, second and third cycle, and another group received clomiphene citrate of the same doses and periods. Both underwent fastingblood glucose and insulin examination on day 3 and 12 of menstrual cycle and USG TVS doppler on day 12. Patients with dominantfolicle on day 12 of menstrual cycle were excluded. We compareddecreased values of HOMA-IR, uterine and spiral artery resistance,endometrium thickness and trilaminar pattern. Between naltrexone and clomiphene citrate group,we found significant differences inHOMA-IR values(p = 0.023), and uterine artery resistance (p = 0.039) and pulsatile indexes(p = 0.02, while there was no significantdifference in spiral arteries resistance index (p = 0.952), endometrial thickness on day 12 (p = 0.305), and trilaminar endometriumpattern (p = 0.395). In conclusion,compared to clomiphane citrate, naltrexone produces remarkable changes in uterine arteriesresistance and HOMA-IR value, while its effect on endometrial thickness, trilaminar pattern, and spiral arteries resistance index isaverage.(MOG 2013;21:94-99)
Keyword :
PCOS, naltrexone, clomiphene citrate, HOMA-IR, resistance,
References :
Sheehan Michael T,(2004) Polycystic Ovarian Syndrome: Diagnosis and Management - : Clinical Medicine & Research
Palomba S, Russo T, Orio Jr F, Falbo A, Mangus F, Sammartino A, Tolino A, Cola A, Carmina E, Zullo F,(2006) Uterine effects of clomiphene citrate in women with polycystic ovary syndrome: a prospective controlled study - : Human Reproduction
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