Pretreatment With CPA-EE, Metformin and Myoinositol in PCOS With High AMH

Pretreatment With CPA-EE, Metformin and Myoinositol in PCOS With High AMH

Women with PCOS with high AMH randomly allocated into group A & B.Cyproterone acetate plus ethinyl estradiol,metformin & myoinositol in group A and Cyproterone acetate plus ethinyl estradiol & metformin are given in group B.Then letrozole 5 mg day 2 to day 6 is given & ovarian response is seen in day 12 for 3 subsequent 3 months .

Women with PCOS with high AMH randomly allocated into group A & B.Cyproterone acetate plus ethinyl estradiol once daily ,metformin 500 mg 3 times daily & myoinositol 750 mg 3 times daily for 3 months in group A and Cyproterone acetate plus ethinyl estradiol once daily ,metformin 500 mg 3 times daily are given in group B. .Then letrozole 5 mg day 2 to day 6 is given & ovarian response is seen in day 12 for 3 subsequent 3 months .Ovarian response is seen by day 12 folliculometry -mature follice ,developinf follicle and endometrial thickness and day 21 serum progesterone

Inclusion Criteria:

• PCOS
• 18-35 years.
• Body Mass Index (BMI): 18.5-29.9 kg/m².
• Infertility.
• Serum AMH level ≥ 5ng/ml .

Exclusion Criteria:

• Serum AMH level > 10 ng/ml
• Endocrine disorder (Hyperprolactinaemia,Uncontrolled hypothyroidism , Diabetes mellitus (DM) type 2,congenital adrenal hyperplasia,cushing syndrome)
• Any known case of pulmonary,cardiac,hepatic & renal disease
• Women having metformin or other drug that could influence hormone metabolism at least 3 months before the study
• Any contraindications to metformin, myoinositol, letrozole & CPA-EE ie. obesity, thromboembolism, breast carcinoma etc & hypersensitivity to these drugs.
• Women with infertility other than anovulation due to PCOS(bilateral tubal block,uterine factor,endometriosis)
• Abnormal semen parameter.