Ovulation induction with clomiphene citrate and metformin in women with polycystic ovary syndrome

Minerva Ginecol. 2014 Jun;66(3):299-301.

Abstract

Aim: Polycystic ovary syndrome (PCOS) is one of the most common causes of ovulatory infertility. It is an endocrine disorders characterized by a high level of male hormones (androgens) and frequent anovulatory cycles associated with multiple ovarian microcysts. The aim of this paper was to evaluate effects of a Clomiphene citrate alone versus a combined treatment (Metformin and Clomiphene citrate).

Methods: A total of 60 women with PCOS and infertility were evaluated. Inclusions criteria were: age 26-34 years, nulliparity, above 3 years of sterility, multiple ovarian microcysts, BMI>27.5, oligomenorrhea/amenorrhea, hyperandrogenism and normal male fertility. Four patients were excluded (renal damage 2, tubal occlusion 1 and Pelvic Inflammatory Disease 1). The remaining 56 were divided into 2 groups: group A were inducted with Clomiphene Citrate alone, while group B were inducted with Clomiphene citrate and Metformin.

Results: In group A we obtained ovulation in 20 women (71.4%), 8 pregnancies (28.5%) and one (3.5%) spontaneous abortion. In group B we obtained ovulation in 24 women (85.7%), 15 pregnancies (53.5%) and no spontaneous abortions.

Conclusion: Combined treatment was found to be more effective (53.5) in improving pregnancy rate compared to monotherapy (28.5%).

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Clomiphene / administration & dosage*
  • Clomiphene / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Fertility Agents, Female / administration & dosage
  • Fertility Agents, Female / therapeutic use
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Infertility, Female / drug therapy*
  • Infertility, Female / etiology
  • Metformin / administration & dosage*
  • Metformin / therapeutic use
  • Ovulation Induction / methods*
  • Polycystic Ovary Syndrome / complications
  • Pregnancy
  • Pregnancy Rate

Substances

  • Fertility Agents, Female
  • Hypoglycemic Agents
  • Clomiphene
  • Metformin