Comparison of resumption of ovulation after cessation of oral contraceptives and medroxyprogesterone acetate in women with polycystic ovary syndrome

Figures & data

Figure 1. Flow chart of the study population.

Table 1. Demographic and clinical characteristics of the study population.

	Oral contraceptive (n = 136)	Medroxyprogesterone acetate (n = 136)	p
Age (years)	23 (19–26)	20 (17–23)	<0.001
Body mass index (kg/m^2)	21.3 (18.8–24.1)	21.9 (19.7–25.2)	0.15
Modified Ferriman-Gallwey score	5 (3–8)	6 (3–9)	0.45
Clinical hyperandrogenism	73 (54.7%)	88 (64.7%)	0.09
Antral follicle count	37 (29–50)	36 (28–50)	0.82
Anti-Müllerian hormone (ng/ml)	13.6 (8.6–18.1)	14.1 (8.2–18.7)	0.84
Total testosterone (ng/ml)	0.5 (0.4–0.7)	0.6 (0.4–0.9)	0.10
Sex hormone-binding globulin (nmol/L)	52.0 (33.5–82.7)	46.9 (29.9–73.9)	0.15
Free androgen index	3.5 (1.9–5.9)	3.6 (2.2–7.5)	0.14
17α-Hydroxyprogesterone (ng/ml)	1.5 (1.1–1.9)	1.4 (1.1–1.8)	0.51
Dehydroepiandrosterone sulfate (ng/ml)	2611 (1756–3580)	2501 (1715–3604)	0.66
Fasting blood sugar (mg/dl)	93 (88–95)	92 (87–95)	0.32
2-h Postprandial blood sugar (mg/dl)	104 (94–120)	111 (93–128)	0.17
Family history of diabetes mellitus	58 (42.7%)	57 (41.9%)	0.96
Duration of medication (months)	3 (3–3)	3 (3–6)	<0.001
Recovery of ovulation	33 (24.3%)	25 (18.4%)	0.24

Values are presented as median (interquartile range) or number (%).

p Values were calculated using the Wilcoxon rank-sum test or chi-square test.

Figure 2. Cumulative density function of probability of treatment assignment. ATT: average treatment effect on the treated.

Table 2. Odds ratio for resumption of ovulation after cessation of medication.

	Univariable logistic regression			Multivariable logistic regression			IPW-CBPS and RA
	OR	95% CI	p Value	Adjusted OR	95% CI	p Value	Adjusted OR	95% CI	p Value
Oral contraceptive	Ref			Ref			Ref
Medroxyprogesterone acetate	0.70	0.39–1.26	0.24	0.98	0.49–1.98	0.96	1.00	0.89–1.12	0.94
p Value by the goodness of fit test						0.19

IPW-CBPS: inverse probability weighting with weights estimated from the covariate balance propensity score; RA: regression adjustment; OR: odds ratio; CI: confidence interval.

The covariate balancing propensity score was based on age, body mass index, and anti-Müllerian hormone and 17α-hydroxyprogesterone levels.

Regression adjustment for age, body mass index, anti-Müllerian hormone and 17α-hydroxyprogesterone levels, and duration of medication.

Table 3. Summary of the balance of variables before and after IPW-CBPS.

	Standardized mean difference		Variance ratio
	Before IPW-CBPS	After IPW-CBPS	Before IPW-CBPS	After IPW-CBPS
Age	−0.47	−1.2 × 10^-8	0.82	1.07
Body mass index	0.18	−7.0 × 10^-8	1.43	1.20
Anti-Müllerian hormone	0.11	−1.3 × 10^-7	2.13	1.59
17α-Hydroxyprogesterone	−0.06	1.4 × 10^-7	0.86	1.05

IPW-CBPS: inverse probability weighting with weights estimated from the covariate balance propensity score.

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.