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Titolo:
Naltrexone effect on pulsatile GnRH therapy for ovulation induction in polycystic ovary syndrome: A pilot prospective study
Autore:
Fulghesu, AM; Ciampelli, M; Belosi, C; Apa, R; Guido, M; Caruso, A; Mancuso, S; Lanzone, A;
Indirizzi:
Catholic Univ Sacred Heart, Dept Obstet & Gynecol, I-00168 Rome, Italy Catholic Univ Sacred Heart Rome Italy I-00168 necol, I-00168 Rome, Italy Osped GB Grassi, Div Obstet & Gynecol, Ostia, Italy Osped GB Grassi Ostia Italy Grassi, Div Obstet & Gynecol, Ostia, Italy OASI, Res Inst, Troina, Italy OASI Troina ItalyOASI, Res Inst, Troina, Italy
Titolo Testata:
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
fascicolo: 7, volume: 24, anno: 2001,
pagine: 483 - 490
SICI:
0391-4097(200107/08)24:7<483:NEOPGT>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
GONADOTROPIN-RELEASING-HORMONE; INSULIN-RESISTANCE; CLOMIPHENE CITRATE; OPIOID TONE; SECRETION; WOMEN; DISEASE; IMPACT; ENDOCRINE; FAILURE;
Keywords:
PCOS; pulsatile GnRH; insulin; LH; opioids; ovulation induction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Fulghesu, AM Catholic Univ Sacred Heart, Dept Obstet & Gynecol, Largo Gemelli 8, I-00168 Rome, Italy Catholic Univ Sacred Heart Largo Gemelli 8 RomeItaly I-00168
Citazione:
A.M. Fulghesu et al., "Naltrexone effect on pulsatile GnRH therapy for ovulation induction in polycystic ovary syndrome: A pilot prospective study", J ENDOC INV, 24(7), 2001, pp. 483-490

Abstract

The aim of the present study was to analyze the opioid influence on LH pulsatility in polycystic ovary syndrome (PCOS) patients and to evaluate the effectiveness of a long-term opioid antagonist (naltrexone) treatment in improving the pulsatile GnRH therapy which is successful in this syndrome. Tenobese women affected by PCOS participated in the study. Patients were hospitalized during the early follicular phase and underwent an oral glucose tolerance test (OGTT) with 75 g of glucose and a pulse pattern study followedby a GnRH test (100 mug iv). All patients were then treated for ovulation induction with pulsatile administration of GnRH (5 mug/bolus every 90 min). Since pregnancies did not occur in any patient, after spontaneous or progestin-induced menstrual cycles, all patients received naltrexone at a dose of 50 mg/day orally for 8 weeks and during treatment repeated the basal protocol study and the ovulation induction cycle with the same modalities. The naltrexone treatment significantly reduced the insulin response to OGTT andthe LH response to GnRH bolus, whereas it did not affect the FSH and LH pulsatility patterns. Concerning the ovulation induction by pulsatile GnRH, naltrexone treatment was able to improve, although not significantly, the ovulation rate (60% pre-treatment vs 90% posttreatment). Furthermore, the maximum diameter of the dominant follicle and the pre-ovulatory estradiol concentration were higher after long-term opioid blockade (follicular diameter 19.5 +/-1.76 mm pre-treatment vs 21.6 +/-2.19 mm post-treatment, p<0.001; maximum estradiol level 728.7<plus/minus>288.5 pmol/l pre-treatment vs 986.4+/- 382.1 pmol/l posttreatment, p<0.05). During the naltrexone-pulsatile GnRH co-treatment two pregnancies occurred. In conclusion, our data show that naltrexone-pulsatile GnRH co-treatment is able to improve the ovarian responsiveness to ovulation induction in obese PCOS patients when compared to pulsatile GnRH alone. This action seems to be related to a decrease of insulin secretion. Further randomized studies should be performed in order to obtain significant conclusions on the possible clinical application. (J. Endocrinol. Invest. 24: 483-490, 2001) (C) 2001. Editrice Kurtis.

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Documento generato il 29/03/20 alle ore 14:31:38