Insulin Resistance in Infertile Sudanese Patients with Poly Cystic Ovarian Syndrome (PCOS) at Laparoscopy

Abstract

Background: Polycystic ovary syndrome (PCOS) is a complex, heterogeneous disorder of uncertain etiology, characterized by irregular menses, chronic anovulation, infertility, hyperandrogenism, and insulin resistance. Aims: To determine insulin resistance in infertile Sudanese patients with PCOS and evaluate its significant relation ship to infertility. Method: A hospital based transversal study was conducted at the Minimal Access Gynecology Surgery (MAGS) unit at Omdurman Maternity Hospital from June 2010 to August 2012 .61 infertile patients with PCOS using Rotterdam 2003 definition and who did not conceive after diet, lifestyle and clomiphene as study group and 61 normo-ovulatory infertile patients with normal ovaries served as a control group at laparoscopy, their serum were sent to the laboratory for estimation of fasting glucose and insulin levels, and then calculation of homeostatic model assessment (HOMA) and p value. Results: 44(73%) out of the 61infertile patients with PCOS were young, obese with BMI>30, hirsutism was seen in 45 (73.5%) and acne was observed in 42 (70%). Fasting blood glucose (FBG) of 100-125 mg/dl, was encountered in 18(30%) and 3 were diabetic (FBG >125). Fasting insulin level was not significantly elevated in the study group, while Insulin resistance calculated using HOMA. Mean HOMA in the obese PCOS group was significantly higher than in the obese normal ovary group (2.68 ± 2.19 versus 1.26 ± 1.05, P = 0.005). Conclusion: The majority of the study population was young, obese and had insulin resistance This finding may have important implications in the short term regarding reproductive performance, and in the long term regarding type 2 diabetes and cardiovascular complications