Rosiglitazone may induce ovulation in metformin-resistant PCOS. (Small Study).

ORLANDO, FLA. -- Rosiglitazone, an insulin-sensitizing agent, holds promise for ovulation induction in metformin-resistant polycystic ovary syndrome, results of a small study suggest.

"Probably half of PCOS [polycystic ovary syndrome] patients don't respond to metformin, and we are quite impressed with the way rosiglitazone has worked," Dr. Robert Casper, one of the study's investigators, said at the annual meeting of the American Society for Reproductive Medicine.

The study, which was presented in poster form, included five infertile women with PCOS who had failed to ovulate with clomiphene citrate (up to 150 mg/day) and at least one cycle of letrozole. The women had also failed to ovulate on a 6-month trial of metformin.

Rosiglitazone was given at 4 mg/day b.i.d.; it was discontinued when a pregnancy was confirmed. Spontaneous ovulation occurred in all patients during the first month of rosiglitazone treatment.

After one documented ovulation, fertility therapy was then individualized to include letrozole administration (2.5 mg/day on days 3-7) and/or midcycle administration of HCG.

Augmentation of ovulation resulted in pregnancy in two patients after 1 and 2 ...