Short-term combined treatment with exenatide and metformin for overweight/obese women with polycystic ovary syndrome

Background:Obesity and insulin resistance(IR)are common features of polycystic ovary syndrome(PCOS).Metformin(MET)increases insulin sensitivity,but it is associated with unsatisfactory weight loss.The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes.This study aimed to explore the therapeutic effects of exenatide once-weekly(QW)combined with MET on body weight,as well as metabolic and endocrinological parameters in overweight/obese women with PCOS.Methods:Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups:MET(500 mg three times a day[TID])or combination treatment(COM)(MET 500 mg TID,exenatide 2 mg QW)for 12 weeks.The primary outcomes were anthropometric changes associated with obesity,and the secondary outcomes included changes in reproductive hormone levels,glucose and lipid metabolism,and C-reactive protein.Results:Forty(80%)patients completed the study.COM therapy was superior to MET monotherapy in reducing weight(P=0.045),body mass index(BMI)(P=0.041),and waist circumference(P=0.023).Patients in the COM group on an average lost 3.8±2.4 kg compared with 2.1±3.0 kg in the MET group.In the COM group,BMI and waist circumference decreased by 1.4±0.87 kg/m2 and 4.63±4.42 cm compared with 0.77±1.17 kg/m2 and 1.72±3.07 cm in the MET group,respectively.Moreover,levels of fasting glucose,oral glucose tolerance test(OGTT)2-h glucose,and OGTT 2-h insulin were significantly lower with COM therapy than with MET(P<0.050).Mild and moderate gastrointestinal reactions were the most common adverse events in both groups.Conclusions:COM therapy was more effective than MET alone in reducing body weight,BMI,and waist circumference,and improving insulin sensitivity in overweight/obese women with PCOS,with acceptable short-term side effects.

Nationwide survey on the usage of ovulation-induction agents among obstetricians and gynecologists in China

Ovulation-induction refers to the type of ovarian stimulation for anovulatory women aimed at restoring normal fertility by generating normal ovulatory cycles and inducing single dominant follicle selection and ovulation. In China, a great number of women with ovulatory disorders are treated by obstetricians and gynecologists (ob-gyns) who are not specialized in infertility. The aim of this study was to investigate the self-reported ob-gyns proficiency of ovulation induction and the most commonly used drug for this procedure.