Effects of Somatostatin Analogue Pretreatment on Ovarian Response to Ovulation Induction in Patients with Polycystic Ovarian Syndrome

Lee, Jong Pyo; Kim, Hong Kwon; Shin, Hye Jin; Kang, Eun Hee; Chae, Hee Dong; Kim, Chung Hoon; Kang, Byung Moon; Chang, Yoon Seok

Abstract

OBJECTIVE
To determine whether the somatostain analogue, octreotide, pretreatment before ovulation induction with human menopausal gonadotropin (hMG) affects ovarian response, and ovulation induction outcome in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC) METHODS: From November 1998 to June 1999, 30 infertile patients with PCOS unresponsive to CC were randomly allocated either octreotide pretreatment (treatment group) (n = 15) or hMG alone (control group) (n = 15) groups. In the treatment group, 100 g of octreotide were administered daily for 7 days after progesterone injection for withdrawal bleeding, and then hMG was administered for ovulation induction.
RESULTS
There were no differences in the total number of hMG ampules required and the duration of hMG administration between the two groups. The number of follicles of 10-14 mm diameter on the day of hCG injection was significantly less in the treatment group than that in the control group (4.3 +/- 2.5 vs. 9.6 +/- 4.4, p < 0.001). The serum estradiol (E2) level on the day of hCG injection was significantly lower in the treatment group, with 1579.2 +/- 421.0 pg/ml compared with 2120.3 +/- 512.7 pg/ml in the control group (p < 0.001). The hematocrit level on the day of hCG injection was also significantly lower in the treatment group than that in the control group (36.9 +/- 2.1% vs. 40.8 +/- 2.9%, p < 0.05). The incidence of severe ovarian hyperstimulation syndrome (OHSS) seemed to be lower in the treatment group, but the difference did not achieve significance (6.7% vs 20.0%).
CONCLUSION
This study suggests that octreotide pretreatment before ovulation induction could improve hormonal milieu compared to hMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.