The Effects of Letrozole and Metformin Combined with Targeted Nursing Care on Ovarian Function, LH, and FSH in Infertile Patients with Polycystic Ovary Syndrome

Abstract

Background. Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder in women of gestational age and the most common cause of female infertility. This study aimed to investigate the effect of letrozole and metformin combined with targeted nursing on ovarian function, LH, and FSH in infertile patients with PCOS. Methods. A total of 72 infertile patients with PCOS were divided into the control group and combined group. The control group was given metformin tablets combined with targeted nursing therapy. The combined group was treated with letrozole on the basis of the control group. Ovarian function, LH, and FSH were compared between the two groups before and after treatment. Results. After treatment, the total effective rate (94.44%) of the combined group was significantly higher than that of the control group (80.56%). After treatment, the levels of HbA1c, FINS, HOMA-IR, TG, and TC in the two groups were lower than those before treatment, and the HDL-C level was higher than that before treatment. The full-term delivery rate, ovulation rate, and normal menstrual rate in the combined group were higher than those in the control group. After treatment, the LH level in the combined group was lower than that in the control group, and the FSH level was higher than that in the control group. After 1 month, 3 months, and 5 months of treatment, RI, PI, and ovarian volume were decreased, and the endometrial thickness was increased in both groups. Also, after 5 months of treatment, the RI, PI, and ovarian volume in the combined group were significantly lower than those in the control group, and the endometrial thickness was significantly higher than that in the control group. There was no statistically significant difference in the incidence of adverse reactions between the two groups. Conclusion. The combination of letrozole and metformin with targeted nursing in the treatment of infertility patients with PCOS has better clinical effect and high safety. It can improve endometrial receptivity and ovarian reserve function and regulate LH and FSH levels.

A comparative study of different treatment modalities of polycystic ovarian syndrome in women of reproductive age group at tertiary care centre

“…In a study by Jiang et al, investigated the effect of letrozole and metformin combined with targeted nursing on ovarian function, luteinizing hormone (LH), and follicle stimulating hormone (FSH) in infertile individuals with PCOS. 36 According to the findings of this research project, the combination of letrozole and metformin has the potential to boost endometrial receptivity and facilitate patients' physical recoveries. By modulating the hypothalamic-pituitary axis's negative feedback, letrozole tablets can also increase the success rate of inducing ovulation, the rate at which women give birth to full-term babies, and the rate at which they have normal menstrual cycles.…”

Vitamin D Status Determines the Impact of Metformin on Gonadotropin Levels in Postmenopausal Women

“…Secondly, correlations with baseline levels suggest that metformin improves gonadotrope secretory function but does not seem to lead to gonadotrope hypofunction, the clinical consequences of which after menopause remain unknown. Thirdly, in light of previous research [2][3][4][5][6][7][8][9][10], metformin treatment may be particularly recommended to postmenopausal women with coexistent hypersecretion of other anterior pituitary hormones (subjects with hyperprolactinemia or primary hypothyroidism) resisting or poorly tolerating specific treatments (dopamine agonists and levothyroxine). Lastly, the putative anti-aging properties of metformin are probably absent in women with vitamin D insufficiency.…”

“…In recent years, it has become clear that metformin, the main first-line medication for the treatment of type 2 diabetes and other insulin resistance states [1], affects the secretory function of the anterior lobe of the pituitary gland [2][3][4][5][6][7][8][9][10]. The drug was found to reduce circulating levels of thyroid-stimulating hormone (TSH) [2,3], prolactin [4,5], and gonadotropins [6][7][8][9][10] if baseline levels of these hormones were elevated.…”

“…In recent years, it has become clear that metformin, the main first-line medication for the treatment of type 2 diabetes and other insulin resistance states [1], affects the secretory function of the anterior lobe of the pituitary gland [2][3][4][5][6][7][8][9][10]. The drug was found to reduce circulating levels of thyroid-stimulating hormone (TSH) [2,3], prolactin [4,5], and gonadotropins [6][7][8][9][10] if baseline levels of these hormones were elevated. Metformin decreased follicle-stimulating hormone (FSH) levels in postmenopausal women [6,7] and in men with hypogonadism [8], as well as luteinizing hormone (LH) levels in women with polycystic ovary syndrome [9,10] and in men with primary testicular failure [8].…”

“…The drug was found to reduce circulating levels of thyroid-stimulating hormone (TSH) [2,3], prolactin [4,5], and gonadotropins [6][7][8][9][10] if baseline levels of these hormones were elevated. Metformin decreased follicle-stimulating hormone (FSH) levels in postmenopausal women [6,7] and in men with hypogonadism [8], as well as luteinizing hormone (LH) levels in women with polycystic ovary syndrome [9,10] and in men with primary testicular failure [8]. Its gonadotropin-lowering properties were potentiated by rosuvastatin treatment [11].…”