@article{ACEJPHCM202442230,
    title = {Effects of Letrozole and Metformin Versus Metformin Alone on Ovarian Activities and Gonadotropin?Releasing Hormone Receptor Antibodies (GnRh) in Iraqi Patients With Polycystic Ovarian Syndrome. (PCOS)},
    journal = {ACE Journal of Public Health and Community Medicine},
    volume = {4},
    number = {2},
    pages = {48-52},
    year = {2024},
    issn = {2520-5633},
    doi = {acejphcm.2024.48.52},
    url = {https://theacepublications.com/article-detail.php?art=230-ACE-JPHCM},
    author = {Shatha and},
    keywords = {GnRh antibodies,PCOS,Letrozole,Metformin},
    abstract = {In recent times, an increasing emphasis has been placed on a novel category of
autoantibodies. This particular group of autoantibodies specifically targets the receptors
that are coupled to G protein (GPCRs), primarily focusing on the 2nd extracellular loop
(ECL2). These autoantibodies have the ability to either trigger or block particular GPCR
signaling pathways, thus playing a crucial role in the pathogenesis of numerous ailments
such as PCOS. The goal of the research is exploring the effects of Letrozole and metformin
versus the sole use of metformin on ovary activities and GnRh antibodies in Iraqi subjects
complaining of PCOS. The current investigation enrolled seventy five women with an age
range of 20?<39 years. Patients were categorized into three groups: metformin group
(positive control group) and they received metformin as 500 mg per?oral (bid), letrozole
group who were treated using 2.5 mg per?oral (bid) and combination groups who received
both agents with similar doses as above. Each group included 25 female. Data about body
mass index (BMI) and the age were included in the study. Serum measurement of GnRhR
antibodies was done before treatment and 90 days after treatment using Enzyme?Linked
Immunosorbent Assay. In addition, assessment of ovarian characteristics was done using
ultrasound. Changes reveled the folowing: at baseline before treatment, there were no
signficant diffrences among study groups (p = 0.983); it was observed that the giving of
either item alone led to a considerable decrease in. level of GnRH antibody, however,
bringing the two items in combination led to more notable decrease in its level (p<0.001).
The metformin alone was able significantly to make larger the volume of dominant follicls
(p = 0.040), Letrozole alone was also able significantly to to make larger the volume of
dominant follicle at (p = 0.006), while used both drugs caused more significant increase
(p<0.001 ). Changes. It was observed that resistive index was reduced following use of
either drugs alone at (p<0.01), however, combined use of both drugs show more signficant
reduction (p<0.001). Combined treatment with letrozole and metformin is safe and
efficient in PCOS women leading to improvement of overall ovarian activity by reducing
levels of GnRh receptors antibodies with possible synergistic effect.}
    }