Effect of Hyperinsulinemia on Anovulation in PCOS

Numerous studies have demonstrated that hyperinsulinemia contributes to the chronic anovulation of PCOS. In the largest long-term study, 305 women with PCOS were randomized to the insulin sensitizer troglitazone (150, 300, or 600 mg daily) or placebo for 44 weeks (10). Women receiving troglitazone at doses of 300 and 600 mg daily had a significantly higher ovulation rate (0.42 and 0.58) than those receiving placebo (0.32; p < 0.05 and 0.0001, respectively). This increase in ovulation rate was dose dependent, suggesting that the improvement in ovulatory function was at least in part accounted for by the improvement in insulin sensitivity.

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