Analysis on influential factors on the recurrence of anovulation of PCOS patients who stop the treatment of combined oral contraceptive
10.3760/cma.j.cn101441-20200708-00384
- VernacularTitle:PCOS患者停用复方口服避孕药治疗后无排卵复发的影响因素分析
- Author:
Hongdi ZHOU
1
;
Zhewei WANG
1
Author Information
1. 同济大学附属第一妇婴保健院妇科，上海 200092
- Publication Type:Journal Article
- Keywords:
Polycystic ovary syndrome;
Insulin resistance;
Anovulation;
Relapse
- From:
Chinese Journal of Reproduction and Contraception
2021;41(9):798-804
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the influential factors on the relapse of anovulation of polycystic ovary syndrome (PCOS) patients who stop the treatment of combined oral contraceptive (COC).Methods:In the prospective observational study from April 2018 to April 2020,259 anovulatory PCOS patients who vistited in Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University were followed up after their androgen lowering therapy via COC for 3 months finished and survival analysis was adopted to analyze the influencing factors of anovulation recurrence.Results:COX multivariate regression showed that for super heavy patients before COC treatment, reducing weight not less than 5% ( HR=0.539, P=0.001) could relay the relapse whereas glycometabolism and insulin metabolism anormality at withdrawal time was promoting factor of relapse ( HR=1.829, P=0.008); for non super heavy patients, hyperandrogenism at withdrawal time may promote relapse of anovulation. K-M test showed that for 50 super heavy patients before COC treatment who reduced weight not less than 5% during treatment, the weight gain after COC withdrawal indicated the shorter relapse time [1.0(1.0,2.0) cycle vs. 3.0(2.0,8.0) cycles, P=0.001]. Among 35 patients whose glucose and insulin metabolism had returned to normal at withdrawal time, those who used maintenance dosage of Metformin after withdrawal had later relapse of anovulation [2.0(1.0, 4.0) cycles vs. 1.0(0.0, 3.0) cycle, P=0.022] than those who did not. Conclusion:To relay the relapse of anovulation after COC treatment, we suggest that super heavy patients reduce weight moderately and remedy glycometabolism anormality, and non super heavy patients reduce androgen to normal before withdrawal. For the patients whose glucose metabolism return to normal at withdrawal time, it is better to continue using maintenance dosage of Metformin after withdrawal.
