Ginecología y Obstetricia de México

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>Journals >Ginecología y Obstetricia de México >Year 2012, Issue 07

Vital RVS, Téllez VS, Ríos CB, Badillo BM, Hinojosa CJC
Insuline Sensitivity in Patients not Responding to Ovulation Induction Using Clomiphene Citrate
Ginecol Obstet Mex 2012; 80 (07)

Language: Español
References: 13
Page: 454-460
PDF: 791.35 Kb.

Full text


Background: The role of insulin resistance (IR) of infertile patients with chronic anovulation in their therapeutic failure to clomiphene citrate (CC) is not quite clear.
Objective: Determine the sensitivity to insulin in patients with chronic anovulation and failure to the treatment with clomiphene citrate.
Material and Methods: A cross-sectional clinical study in infertile patients with clomiphene citrate resistance and in patients with adequate response to clomiphene citrate was carried out. In all patients insulin resistance was determined by the rate of glucose/insulin, HOMA (Homestatic Model Assessment) and the insulin sensitivity test. For the inferential statistical analysis, a Student’s t test for independent samples was used.
Results: The average total basal insulin was 19.6 ± 8.1 µU/mL. We observed higher concentrations in the clomiphene citrate resistance group (22.1 ± 8.9 vs 15.8 ± 5.1 mU/mL p=0.07). The glucose/insulin rate was statistically minor in patients with resistance to clomiphene citrate (4.2 ± 1.9 versus 6.9 ± 2.1 p=0.02), but HOMA was not significantly different in both groups (4.3 ± 1.4 vs 3.9 ± 1.3 p=0.6). The total rate of glucose disappearance (KIIT) was 4.1 ± 1.2. However, the statistical analysis did not show significant statistical differences between the two groups.
Conclusions: Our preliminary results suggest that insulin resistance can be a mechanism involved in the pharmacologic response to ovulation induction in infertile patients, but coexisting pathophysiological mechanisms such as hyperandrogenism might also account for the lack of response to clomiphene citrate.

Key words: anovulation, clomiphene citrate, insulin resistance.


  1. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med 2005;352:1223-1236.

  2. Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Up 2009;15:477-488.

  3. Homburg R. Androgen circle of polycystic ovary syndrome. Hum Reprod Up 2009;24:1548-1555.

  4. Vital Reyes VS, Enríquez Miranda MC, Martínez Martínez E, Coronel MC, Hinojosa Cruz JC, Téllez Velasco S. Tasa glucosa-insulina y composición de grasa corporal en pacientes con anovulación crónica y esterilidad. Ginecol Obstet Mex 2002;70:71-75.

  5. Bhattacharya SM. Metabolic syndrome in females with polycystic ovary syndrome and International Diabetes Federation criteria. J Obstet Gynecol Res 2008;34:62-66.

  6. ESRHE/ASRM PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008;23:462-477.

  7. The Practice Committee of the American Society for Reproductive Medicine. Use of clomiphene citrate in women. Fertil Steril 2006;86:S187-S193.

  8. The Practice Committee of the American Society for Reproductive Medicine. Gonadotropin preparations: past, present, and future perspectives. Fertil Steril 2008;90:S13-S20.

  9. Amador N, Espinoza G, Guizar JM, González M, Alpízar M. Comparasion of HOMA IR with the minimal model for measuring insulin sensitivity in polycystic ovary syndrome. Rev Invest Clin 2001;53:407-412.

  10. Espinosa de los Monteros A, Ayala J, Sanabria LC, Parra A. Serum Insulin in clomiphene responders and nonresponders with polycystic ovarian disease. Rev Invest Clin 1995;47:347-353.

  11. Palomba S, Falbo A, Zullo F, Orio F. Evidence-Based and potential benefits of metformin in the polycystic ovary syndrome: A Comprensive Review. Endocrine Reviews 2009;30:1-50.

  12. Borai A, Livingstone C, Kaddam, Ferns G. Selection of the appropriate method for the assessment of insulin resistance. BMC Med Res Methodol 2011;11:158-168.

  13. Borai A, Livingstone C, Ferns GA. The biochemical assessment of insulin resistance. Ann Clin Biochem 2007;44:324-342.

>Journals >Ginecología y Obstetricia de México >Year 2012, Issue 07

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