RESUMO
OBJECTIVE: To compare the ovulation rate between raloxifene and clomiphene citrate (CC) in patients with polycystic ovary syndrome (PCOS). DESIGN: Double-blind, randomized, superiority clinical trial. SETTING: Tertiary university hospital. PATIENT(S): Women with ovulatory dysfunction and PCOS based on the Rotterdam criteria. INTERVENTION(S): One of two oral treatments: 5 days of 100 mg/day of CC or R. MAIN OUTCOME MEASURE(S): Ovulation, based on follicle collapse on serial ultrasound and midsecretory serum progesterone concentration (≥3 ng/dL). RESULT(S): The women with PCOS (n = 82) were randomized to receive CC (n = 40) or raloxifene (n = 42). From these, 68 patients finished the trial according to the protocol (CC: n = 37; raloxifene: n = 31). There were no statistically significant differences between the groups in ovulation rates per an intention-to-treat analysis based on ultrasound alone (CC: 21 of 40 vs. raloxifene: 17 of 42) or on progesterone levels (CC: 16 of 40 vs. raloxifene: 11 of 42). No serious adverse events were observed in either group. CONCLUSION(S): No statistically significant difference in ovulation was observed between raloxifene and clomiphene citrate in patients with PCOS with ovulatory dysfunction.
Assuntos
Clomifeno/administração & dosagem , Infertilidade Feminina/tratamento farmacológico , Indução da Ovulação/métodos , Ovulação/efeitos dos fármacos , Síndrome do Ovário Policístico/tratamento farmacológico , Cloridrato de Raloxifeno/administração & dosagem , Adulto , Clomifeno/efeitos adversos , Antagonistas de Estrogênios/administração & dosagem , Antagonistas de Estrogênios/efeitos adversos , Feminino , Fármacos para a Fertilidade Feminina/administração & dosagem , Fármacos para a Fertilidade Feminina/efeitos adversos , Humanos , Infertilidade Feminina/etiologia , Síndrome do Ovário Policístico/complicações , Progesterona/sangue , Estudos Prospectivos , Cloridrato de Raloxifeno/efeitos adversos , Adulto JovemRESUMO
The endometrium of women with hydrosalpinx has an increased number of neutrophils and lower expression of elafin, an elastase inhibitor and natural antimicrobial molecule. These findings suggest that women with hydrosalpinx have a reduced antimicrobial and antielastase activity.