The first report of Clonidine invivo/invitro effects as a new pharmacological strategy in the infertile women with polycystic ovary syndrome

Objective: Women with polycystic ovary syndrome (PCOS) suffer from sympathetic nervous system (SNS) hyperactivity. Clonidine as the alpha-۲ adrenoceptor agonist is widely used for modulation of SNS output.Study designThis study was designed in two sections: in-vivo / in-vitro and was performed from February ۲۰۱۶ to December ۲۰۱۷. Eighty women with PCO participated in this randomized clinical trial (in-vivo). Polycystic ovary morphology (PCOM) and pregnancy rate were the main outputs which were evaluated by oral dosing of clonidine (۰.۱ mg) tablet twice a day for two months. A case/control study of cumulus cell culture was another part (in-vitro) of this study. Clonidine was added to the culture for two study groups (PCO women with drug / without drug) and two control groups (egg donors with drug / without drug), that all of them were candidate for IVF. Ovulation stimulant drugs were administrated for all groups. After the puncture, cumulus cells were collected for treatment by clonidine.ResultsThe pregnancy rate significantly more occurred in the clonidine group (P = ۰.۰۰۲). Other results of the clinical trial indicate a significant increase in the total number of antral follicle count (AFC) (p = ۰.۰۰۶). The results of the in-vitro assessment in cumulus cell culture showed that in the non-treatment group of PCO women, the mRNA expression of ADR-α۱ was higher than the control group (P-value <۰.۰۰۱). In treatment PCO group with clonidine, ADR-α۱ expression decreased (P-value = ۰.۰۴۲) similar mRNA expression of ADR-α۲. ThemRNA expression of ADR-β۲ in PCO group was higher than the control (P-value <۰.۰۰۱). The intensity of this effect was ADRα۱