Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome.
OBJECTIVE
To evaluate the effect of metformin therapy on hyperandrogenism, insulin resistance, cervical scores, ovulation, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS).


METHODS
Prospective, randomized, double-blind, placebo-controlled study.


METHODS
Infertility clinic of a tertiary referral center.


METHODS
Fifty-six women with clomiphene citrate-resistant PCOS.


METHODS
Two cycles of oral metformin therapy (850 mg, twice daily) in group I and placebo therapy (twice daily) in group II. Clomiphene citrate (100 mg/day) on cycle days 3-7 of the second cycle in both groups.


METHODS
Insulin, T, DHEAS, FSH, LH, body mass index (BMI), waist-to-hip ratio, endometrial thickness, cervical score, ovulation, and pregnancy rates in clomiphene-induced cycles after metformin therapy.


RESULTS
Metformin therapy resulted in a significant decrease in total T, LH level, LH/FSH ratio, insulin resistance, and mean BMI. No difference in waist-to-hip ratio, DHEAS level, and fasting insulin level was observed. Clomiphene citrate induction resulted in higher ovulation rates and thicker endometrium in the metformin group than in the placebo group. There was higher cumulative pregnancy rate in the metformin group; however, there was no significant difference in the pregnancy rate between the two groups.


CONCLUSIONS
Metformin therapy not only decreases hyperandrogenism and insulin resistance but also improves ovulation rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with PCOS.
Kocak
Müberra
M
Department of Obstetrics and Gynecology, SSK Ankara Maternity and Women's Health Teaching Hospital, Ankara, Turkey.
Caliskan
Eray
E
Simsir
Coskun
C
Haberal
Ali
A
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D004311:Double-Blind Method; D004351:Drug Resistance; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology; D007328:Insulin / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D010919:Placebos; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy / Q000706:statistics & numerical data*; D017211:Treatment Failure
D005300:Fertility Agents, Female; D012739:Gonadal Steroid Hormones; D007004:Hypoglycemic Agents; D007328:Insulin; D010919:Placebos; D002996:Clomiphene; D008687:Metformin