Polycysctic Ovarian Syndrome (pcos); Pregnancy Rate following Ovulation Induction by Clomiphene Alone and with Combination of Metformin
نویسندگان
چکیده
.. Objective: To compare effectiveness of clomiphene alone and in combination with metformin in terms of conception rate in patients presenting with polycystic ovary syndrome. Study Design: Randomized clinical trail. Place and duration of study: Department Obstetrics and Gynecology Unit I, Nishtar Hospital Multan, 6 months from 12th September 2009 to 11th March 2010. Methodology: Primary subfertile women visiting outpatient department of Nishtar Hospital Multan with significant irregular menstrual cycle, oligo menorrhea and ultrasonographic features of polycystic ovaries were enrolled in the study. Semen samples from male partners were analyzed according to the WHO criteria. Women whose partner’s semen analysis was abnormal were excluded from study. Group ‘A’ was given clomiphene citrate alone and second group (i.e. group B) was given colmiphene citrate and metformin. All patients were followed till six cycles for regularity of menstrual cycle (determined by history) ovulation by follicular tracking on ultrasonography, if patient (conceived), conception was confirmed by urine pregnancy test and gestational sac on ultrasonography pelvis. Final outcome was measured at six month. Information was entered in specifically designed proforma. Results: Frequency of PCOS was 14.05%. Mean age of the patients was 31.03 ± 0.58 vs. 29.89 ± 0.53 years in group A and B respectively. Oligomenorrhea was present in 18(50%) vs. 18 (50%) women, amenorrhea in 7(19.4%) vs. 8(22.2%) patients and weight gain in 14(38.9%) vs. 15(41.7%) cases in group A and B respectively. Conception was achieved in 26(72.2%) vs. (18(50.0%) patients in group A and B respectively. Conclusions: Metformin does not seem to help in achieving higher rates of pregnancy when combined with CC as compared to CC alone.
منابع مشابه
Effects of Metformin on Ovulation and Pregnancy Rate in Women with Clomiphene Resistant Poly Cystic Ovary Syndrome
Background To evaluate the effect of metformin on ovulation and pregnancy rate in clomiphene citrate resistant women with polycystic ovary syndrome (PCOS). MaterialsAndMethods In this clinical trial each patient, regarding her previous resistance to Clomiphene, served as her own control. A total of 35 clomiphene citrate resistant PCOS patients, referring to Royan institute were studied. Clomiph...
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Background: Clomiphen citrate (CC) is the first line therapy for women with infertility and poly cystic ovary syndrome( PCOS).However, 20-25% of women are resistant to CC and do not ovulate. The Background of this study is to evaluate the efficacy of sequential treatment of metformin and incremental doses of letrozole in induction of ovulation in cases of clomiphen citrateresistant (CC- R) PCOS...
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Is metformin indicated as primary ovulation induction agent in women with PCOS? A systematic review and meta-analysis.
BACKGROUND A recent meta-analysis has proven that metformin (M) is highly effective for ovulation induction in the clomiphene citrate (CC)-resistant patient. There is uncertainty whether M should be introduced as a primary ovulation induction agent in polycystic ovarian syndrome (PCOS). METHODS We conducted a systematic review and meta-analysis to establish if M is better when given alone or ...
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Metformin alone compared with placebo increases the ovulation rate in women with polycystic ovary syndrome (PCOS) but should not be used as first-line therapy for anovulation because oral ovulation induction agents such as clomiphene citrate or letrozole alone are much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS. There is fair evidence that metform...
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