多囊卵巢综合征妇女停用口服避孕药和醋酸甲羟孕酮后恢复排卵的比较。

IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-02-02 DOI:10.1080/09513590.2024.2309349
Soo Jin Han, Hoon Kim, Seung-Yup Ku, Chang Suk Suh
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引用次数: 0

摘要

目的:口服避孕药(OCP)和环状醋酸甲羟孕酮(MPA)被广泛用于控制多囊卵巢综合征(PCOS)女性的月经异常。我们的目的是评估多囊卵巢综合征妇女停用 OCP 和 MPA 后恢复排卵的几率:我们对 2015 年 9 月至 2019 年 3 月期间接受 OCPs 或周期性 MPA 治疗的 PCOS 女性患者进行了一项回顾性研究。停药后,使用基础体温和/或测量血清孕酮评估排卵情况。采用多变量逻辑回归评估恢复排卵的几率。此外,还使用反概率加权分析和基于协变量平衡倾向评分的回归调整进行了双重稳健分析,以调整协变量对治疗分配的影响:在272名患有多囊卵巢综合征的妇女中,136人接受了OCPs治疗,136人接受了周期性MPA治疗。停用 MPA 后,18.4% 的妇女(n = 25)恢复排卵,停用 OCP 后,24.3% 的妇女(n = 33)恢复排卵。MPA使用者恢复排卵的几率与OCP使用者相当(调整后的几率比(aOR)为1.00,95%置信区间(CI)为0.89-1.12)。在因缺失值而进行多重估算后,结果没有发生重大变化(aOR 0.99,95% CI 0.89-1.10):结论:在患有多囊卵巢综合征的女性中,MPA使用者在停药后恢复排卵的几率与OCP使用者相似。对于禁用 OCP 或拒绝服用 OCP 的妇女,周期性 MPA 可以作为 OCP 的良好替代品。
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Comparison of resumption of ovulation after cessation of oral contraceptives and medroxyprogesterone acetate in women with polycystic ovary syndrome.

Objective: Both oral contraceptive pills (OCPs) and cyclic medroxyprogesterone acetate (MPA) are widely used to control menstrual abnormalities in women with polycystic ovary syndrome (PCOS). We aimed to evaluate the chance of ovulation resumption after cessation of OCPs and MPA in women with PCOS.

Methods: A retrospective study was conducted of women with PCOS who were treated with OCPs or cyclic MPA from September 2015 to March 2019. After cessation of medication, ovulation was assessed using basal body temperature and/or measurement of serum progesterone. The odds ratio for ovulation resumption was assessed with multivariable logistic regression. Additionally, doubly robust analysis was performed with inverse-probability-weighted analysis and regression adjustment based on the covariate balancing propensity score to adjust for the effect of covariates on the treatment assignment.

Results: Among 272 women with PCOS, 136 were prescribed OCPs and 136 were prescribed cyclic MPA. Ovulation resumed in 18.4% of women (n = 25) after cessation of MPA and in 24.3% of women (n = 33) after cessation of OCPs. The odds of ovulation resumption in MPA users were comparable with those in OCP users (adjusted odds ratio (aOR) 1.00, 95% confidence interval (CI) 0.89-1.12). After multiple imputation due to missing values, the results did not change substantially (aOR 0.99, 95% CI 0.89-1.10).

Conclusions: Among women with PCOS, MPA users have a similar chance of ovulation resumption as OCP users after cessation of medication. Cyclic MPA can be a good alternative to OCPs in women for whom OCPs are contraindicated or who decline to take OCPs.

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来源期刊
Gynecological Endocrinology
Gynecological Endocrinology 医学-妇产科学
CiteScore
4.40
自引率
5.00%
发文量
137
审稿时长
3-6 weeks
期刊介绍: Gynecological Endocrinology , the official journal of the International Society of Gynecological Endocrinology, covers all the experimental, clinical and therapeutic aspects of this ever more important discipline. It includes, amongst others, papers relating to the control and function of the different endocrine glands in females, the effects of reproductive events on the endocrine system, and the consequences of endocrine disorders on reproduction
期刊最新文献
Statement of Retraction: Combined metformin and clomiphene citrate versus highly purified FSH for ovulation induction in clomiphene-resistant PCOS women: a randomised controlled trial. Statement of Retraction: Minimal stimulation or clomiphene citrate as first-line therapy in women with polycystic ovary syndrome: a randomized controlled trial. Treatment of ovarian damage induced by chemotherapeutic drugs in female rats with G-CSF and platelet-rich plasma(PRP): an immunohistochemical study correlation with novel marker INSL-3. Update on the combination of myo-inositol/d-chiro-inositol for the treatment of polycystic ovary syndrome. Comparative effects of the antioxidant glutathione with metformin and Diane-35 on hormonal, metabolic, and inflammatory indicators in a DHEA-induced PCOS rat model.
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