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Polikistik over sendromunda tedavi seçeneklerinin antimüllerian hormona etkisi

The effect of polycyctics ovary syndrome treatment modalities on antimullerian hormone

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  1. Tez No: 247158
  2. Yazar: ZEYNEP KAMALAK
  3. Danışmanlar: PROF. DR. NİLGÜN TURHAN
  4. Tez Türü: Tıpta Uzmanlık
  5. Konular: Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
  6. Anahtar Kelimeler: Belirtilmemiş.
  7. Yıl: 2010
  8. Dil: Türkçe
  9. Üniversite: Fatih Üniversitesi
  10. Enstitü: Tıp Fakültesi
  11. Ana Bilim Dalı: Kadın Hastalıkları ve Doğum Ana Bilim Dalı
  12. Bilim Dalı: Belirtilmemiş.
  13. Sayfa Sayısı: 64

Özet

Amaç: Bu çalışmada amacımız son yıllarda over rezervinin en iyi belirteçlerinden biri olarak kabül edilen Antimüllerian Hormonun (AMH) Polikistik over sendromlu (PCOS) hastalarda tedavi seçenekleri ile değişimini araştırmaktır. Anovulatuar oligoamenorenin en sık nedeni olan ve yardımcı üreme tekniklerine sık olarak ihtiyaç duyulan PCOS'da folikülogenezis negatif yönde etkilenmektedir. Çalışmamızda PCOS'un tedavi seçeneklerinden Metformin Hydrochloride 850 mg (Glucophage 850 mg) ve ethinyl estradiol (EE) 35 µg ve cyproterone acetate (CA) 2 mg (Diane 35 tablet; Schering) kullanımı sonrası serum AMH seviyelerini ve diğer parametrelerle ilişkisi araştırdık.Gereç ve Yöntem: Çalışmamız Fatih Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde prospektif olarak planlandı. Haziran 2009?Kasım 2009 tarihleri arasında hastanemiz jinekoloji ve endokrinoloji polikliniklerine başvuran 17-35 yaşları arasında, BKI

Özet (Çeviri)

Aim: In this study the object was to determine the relation between diffrent treatment modelities and evaluation of AMH levels in Polycystic ovary syndrome (PCOS). PCOS is one of the most common cause of anovulatory infertility. In recent years in follicular growth implies the potantial value of AMH as a marker for the type and extend of ovarian dysfunction in anovulatory women. In the study we examined the evaluation of AMH levels and relation with other parametres in PCOS cases after treatment of Metformin Hydrochloride 850 mg (Glucophage 850 mg) and ethinyl estradiol (EE) 35 µg, cyproterone acetate (CA) 2 mg (Diane 35; Schering)Materials-Methods: This was a prospective clinical trial in which diagnosis with 84 PCOS patients based on Rotterdam revised criteria were compared to normoovulatory 28 cases. The study was conducted between June 2009-November 2009. Participants were recruited from the Obstetrics and Gynecology polyclinics and Internal Medicine Endocrinology polyclinics of Fatih University Faculty. Cases with the age 17- 35 years and body mass index (BMI) less than 30 kg/ m2 were taken in to the study. A full history was taken and clinical examination was performed. They were informed about the study and informed consent was taken. Approval was obtained from the institutional Review Board of the Fatih University Faculty of medicine.Weight and height were measured and BMI was calculated as weight (kg)/ height (m2) Hırsutism was confirmed by scoring system of Ferriman and Gallwey. Polycystic ovaries were defined as 10 or more follicles (measuring 2-9 mm) per ovary and the ovarian volume was considered to be increased above 10 ml. Ovarian volume was calculated using the simplified formula for a prolate ellipsoid (05x length x width x thickness).Subjects with clinically significant endocrine disorder as tyroid disease, hyperprolactinemia, Cushing syndrome, congenital adrenal hyperplasia or diabetes were excluded. Smoking, taking alcohol or medications in the last 6 months as glucocorticoids, thyroid drugs, ovulation induction agents, antiandrogenics or oral contraceptives and having abortion in previous history were excluded. Patient with ultrasonographic presence of endometrioma, dermiod cysts or functional cysts that can affect ovarian function or previous ovarian surgery were also excluded.The patients who were previously taking theraphy in last six months in our clinic divided as Metformin PCOS group, Diane 35 PCOS group, no medicine PCOS group and control group. For every groups venous blood sampling was taken from all women in the early follicular phase (cycle days 3?5) in the morning (08- 09 am) after 8-12 hours fasting. CBC, FBS, AST, ALT, urea, creatinin, FSH, LH, E2, PRL, Total testeron, DHEAS, 17-OHP, insulin and AMH levels were measured.Results: Mean age and height of the groups were similiar. There was significant difference between groups in terms of weight. When compared with control group, weight was significanty higher in no medicine PCOS group, Metformin PCOS group and Diane 35 PCOS groups (p=0,046; p=0,003 and p=0,005 respectively). There was significant difference in terms of BMI between groups. BMI of three PCOS groups were higher than control group (p=0,012; p

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