Comparative effectiveness of pioglitazone, raloxifene, and combined pioglitazone-raloxifene of ovulation-induction therapies in infertile patients with resistant polycystic ovary syndrome

Abstract

Rana Hussein Kutaif, Mustafa G. Alabbassi, Weqar Akram Hussein, Zainab Faleh Abdel Hassan, Shatha Khayun Ali.

Background: Clomiphene citrate (CC) has been the first line of treatment for ovulatory disorders for more than four decades, and clomiphene citrate alternative therapy is limited. This study aimed to compare the efficacy between (pioglitazone, raloxifene, and the combination of pioglitazone and raloxifene) for ovulation induction, and pregnancy in infertile women with resistance polycystic ovary.
Materials and methods: Eighty seven women suffering of polycystic ovary infertility have been assigned randomly to achieve ovulation induction with pioglitazone, 15 mg bid (GroupI), raloxifene, 60 mg bid for five days starting on the 3rd day of spontaneous or triggered menstruation, (Group II), or by the combination of pioglitazone, 15 mg twice daily and raloxifene 60 mg twice daily (GroupIII). Folliculometry was started from day 10 of the cycle and repeated every 2 days until day 16 of the cycle. HCG (5000-10000 IU) was administered I.M while at least one oocyte ≥ 18 mm was developed. To diagnose pregnancy, serum β-HCG was assessed 2 weeks after HCG injection.
Results: Variations in pregnancy rates among the three study groups were statistically important 20% (5/25), (30% (9/30), and 34.4% (11/32) for (pioglitazone, raloxifene, and the combination of the treatment groups, respectively) and the ovulation rates were, 44% (11/25), 73.3% (22/30), and 78.1% (25/32) for pioglitazone, raloxifene, and the combination of treatment groups, respectively).
Conclusion: