Effects of lianggu decoction combined with clomiphene on insulin resistance, ovarian hemodynamics, and pregnancy outcomes in infertile patients with obese polycystic ovary syndrome

To investigate the effects of Lianggu Decoction combined with clomiphene on insulin resistance, ovarian hemodynamics, and pregnancy outcomes in infertile patients with obese polycystic ovary syndrome (PCOS). A total of 127 infertile patients with obese PCOS admitted between February 2022 and December 2023 were enrolled in the study. Patients were randomly assigned into a control group (n = 64, clomiphene alone) and an observation group (n = 63, clomiphene + Lianggu Decoction). Clinical efficacy, insulin resistance indices, blood glucose, blood lipids, body mass index (BMI), ovarian hemodynamics, serum sex hormone levels, ovulation rate, pregnancy outcomes, and adverse reactions were compared between the two groups. The total effective rate was significantly higher in the observation group (P < 0.05). After treatment, fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and BMI were significantly lower in the observation group (P < 0.05). Fasting insulin (FINS) and the homeostasis model assessment of insulin resistance (HOMA-IR) were also lower in the observation group, while the HOMA of β-cell function (HOMA-β) was higher (P < 0.05). In terms of ovarian hemodynamics, pulsatility velocity spectrum (PVS) and pulsatility index (PI) were higher, whereas the resistance index (RI) was lower in the observation group (P < 0.05). Additionally, serum estradiol (E2), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were lower in the observation group (P < 0.05). The ovulation rate and clinical pregnancy rate were significantly higher, while the miscarriage rate was lower in the observation group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Lianggu Decoction combined with clomiphene is effective in treating infertility in obese PCOS patients. It can significantly improve insulin resistance, glucose and lipid metabolism, sex hormone levels, and ovarian hemodynamics, thereby enhancing pregnancy outcomes.