Objective: To compare outcomes,of short and ultralong ovarian stimulation protocols for in vitro ... more Objective: To compare outcomes,of short and ultralong ovarian stimulation protocols for in vitro fertilization in patients with endometriosis. Patients and Methods: ,The present non-randomized clinical study was conducted from September 1996 to December,2004. Seventy-four cycles of in vitro fertilization in patients with endometriosis,were evaluated. Thirty-seven cycles ,which ,were ,induced ,by short protocol (GnRHa and Follicle Stimulating Hormone, FSH or Human Menopausal Gonadotropin, HMG) and thirty-seven cycles which were induced by ultralong protocol (GnRHa and FSH or HMG) were compared ,according to the ,number ,of retrieved oocytes, number of embryos, cancellation rate of cycles, embryo quality, fertilization rate and pregnancy,rates. Results: The ,numbers ,of the ,retrieved oocytes and embryos ,were similar in both protocols (p=.056 and p=.107). Clinical pregnancy ,rates per oocytes retrieved cycle were 11.8% and 13.9% in short and ultralong protocol, respectively (p = 1.00...
The aim of this retrospective study was to assess whether acanthosis nigricans is a predictive fa... more The aim of this retrospective study was to assess whether acanthosis nigricans is a predictive factor for abnormal glucose tolerance (AGT) in Asian women with polycystic ovary syndrome (PCOS). Data from the record forms and electronic form of 121 PCOS women who consecutively attended the Reproductive Endocrinology and Infertility Unit were reviewed. In accordance with the unit's guidelines, all women received a physical examination, had anthropometric measurements taken and underwent as a 75-g oral glucose tolerance test after diagnosis. Their age, body mass index (BMI) and waist/hip ratio (WHR) was 29.1+/-6.1 years, 27.4+/-6.8 kg/m2 and 0.84+/-0.6 (mean+/-standard deviation), respectively. The prevalence of AGT was 42.9%, with 1.6% having impaired fasting glucose, 32.3% having impaired glucose tolerance and 9.1% having type 2 diabetes mellitus. The PCOS women with acanthosis nigricans had significantly higher BMI, WHR, fasting glucose, 2-h post-load glucose, fasting insulin, 2-h post-load insulin and prevalence of AGT compared with those without acanthosis nigricans. By logistic regression analysis, acanthosis nigricans and WHR were independent predictors for AGT, with an odds ratio (95% confidence interval) of 2.7 (1.1-7.1) and 10.1 (1.8-20.7), respectively. In conclusion, acanthosis nigricans was demonstrated as a predictive factor for AGT in Asian women with PCOS.
The aim of this study was to assess the efficacy of metformin on induction of ovulation in Asian ... more 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.
To compare the effect of the aromatase inhibitor letrozole and clomiphene citrate (CC) on superov... more To compare the effect of the aromatase inhibitor letrozole and clomiphene citrate (CC) on superovulation in women with normal ovulation. A cross-over randomized study of 22 women with normal ovulation, divided randomly into two equal cohorts, was carried out. Each group of 11 women was randomly allocated to take letrozole or CC for one cycle. After washing out for one cycle, the alternative drug was administered in the subsequent cycle. The number and size of mature follicles, endometrial thickness, and estradiol and progesterone levels were monitored. The number of mature follicles and estradiol levels on ovulation day were significantly lower in the letrozole group than the CC group (p < 0.05 for both). However, no differences between the two groups in endometrial thickness and pattern were observed. Progesterone levels showed ovulation in all cycles. The administration of 50 mg CC on days 3-5 was superior to 2.5 mg letrozole for superovulation induction in women with normal ovulation.
Objective: To compare outcomes,of short and ultralong ovarian stimulation protocols for in vitro ... more Objective: To compare outcomes,of short and ultralong ovarian stimulation protocols for in vitro fertilization in patients with endometriosis. Patients and Methods: ,The present non-randomized clinical study was conducted from September 1996 to December,2004. Seventy-four cycles of in vitro fertilization in patients with endometriosis,were evaluated. Thirty-seven cycles ,which ,were ,induced ,by short protocol (GnRHa and Follicle Stimulating Hormone, FSH or Human Menopausal Gonadotropin, HMG) and thirty-seven cycles which were induced by ultralong protocol (GnRHa and FSH or HMG) were compared ,according to the ,number ,of retrieved oocytes, number of embryos, cancellation rate of cycles, embryo quality, fertilization rate and pregnancy,rates. Results: The ,numbers ,of the ,retrieved oocytes and embryos ,were similar in both protocols (p=.056 and p=.107). Clinical pregnancy ,rates per oocytes retrieved cycle were 11.8% and 13.9% in short and ultralong protocol, respectively (p = 1.00...
The aim of this retrospective study was to assess whether acanthosis nigricans is a predictive fa... more The aim of this retrospective study was to assess whether acanthosis nigricans is a predictive factor for abnormal glucose tolerance (AGT) in Asian women with polycystic ovary syndrome (PCOS). Data from the record forms and electronic form of 121 PCOS women who consecutively attended the Reproductive Endocrinology and Infertility Unit were reviewed. In accordance with the unit's guidelines, all women received a physical examination, had anthropometric measurements taken and underwent as a 75-g oral glucose tolerance test after diagnosis. Their age, body mass index (BMI) and waist/hip ratio (WHR) was 29.1+/-6.1 years, 27.4+/-6.8 kg/m2 and 0.84+/-0.6 (mean+/-standard deviation), respectively. The prevalence of AGT was 42.9%, with 1.6% having impaired fasting glucose, 32.3% having impaired glucose tolerance and 9.1% having type 2 diabetes mellitus. The PCOS women with acanthosis nigricans had significantly higher BMI, WHR, fasting glucose, 2-h post-load glucose, fasting insulin, 2-h post-load insulin and prevalence of AGT compared with those without acanthosis nigricans. By logistic regression analysis, acanthosis nigricans and WHR were independent predictors for AGT, with an odds ratio (95% confidence interval) of 2.7 (1.1-7.1) and 10.1 (1.8-20.7), respectively. In conclusion, acanthosis nigricans was demonstrated as a predictive factor for AGT in Asian women with PCOS.
The aim of this study was to assess the efficacy of metformin on induction of ovulation in Asian ... more 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.
To compare the effect of the aromatase inhibitor letrozole and clomiphene citrate (CC) on superov... more To compare the effect of the aromatase inhibitor letrozole and clomiphene citrate (CC) on superovulation in women with normal ovulation. A cross-over randomized study of 22 women with normal ovulation, divided randomly into two equal cohorts, was carried out. Each group of 11 women was randomly allocated to take letrozole or CC for one cycle. After washing out for one cycle, the alternative drug was administered in the subsequent cycle. The number and size of mature follicles, endometrial thickness, and estradiol and progesterone levels were monitored. The number of mature follicles and estradiol levels on ovulation day were significantly lower in the letrozole group than the CC group (p < 0.05 for both). However, no differences between the two groups in endometrial thickness and pattern were observed. Progesterone levels showed ovulation in all cycles. The administration of 50 mg CC on days 3-5 was superior to 2.5 mg letrozole for superovulation induction in women with normal ovulation.
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