Metformin administration versus laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: a prospective parallel randomized double-blind placebo-controlled trial.
At present, it is unclear what the role is of laparoscopic ovarian diathermy (LOD) and of metformin administration as second-line treatments for ovulation induction in women with polycystic ovary syndrome (PCOS) after failure of clomiphene citrate (CC) treatment. The aim of the present study was to compare in a randomized double-blind placebo-controlled fashion the effectiveness of LOD with metformin administration in the treatment of CC-resistant women with PCOS. A total of 120 overweight primary infertile anovulatory CC-resistant women with PCOS were enrolled and randomized into two groups of treatment. Group A underwent diagnostic laparoscopy, whereas group B underwent LOD. At hospital discharge, the patients were treated for 6 months with metformin cloridrate (group A; 850 mg twice daily) or with multivitamins (group B). The ovulation, pregnancy, abortion, and live-birth rates were evaluated. At the end of the study, the total ovulation rate was not statistically different between both treatment groups (54.8 vs. 53.2% [correction] in groups A and B, respectively), whereas the pregnancy (21.8 [correction] vs. 13.4%), the abortion (9.3 [correction] vs. 29.0%), and the live-birth (86.0 [correction] vs. 64.5%) rates were significantly (P < 0.05) different between the two groups. Our data show that metformin administration is more effective than LOD in overall reproductive outcomes in overweight infertile CC-resistant women with PCOS.
Department of Gynecology and Obstetrics, University Magna Graecia of Catanzaro, Italy. stefanopalomba@tin.it
Stefano
S
Palomba
Francesco
F
Orio
Luciano Giovanni
LG
Nardo
Angela
A
Falbo
Tiziana
T
Russo
Domenico
D
Corea
Patrizia
P
Doldo
Gaetano
G
Lombardi
Achille
A
Tolino
Annamaria
A
Colao
Fulvio
F
Zullo
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics; D002996:Clomiphene / Q000627:therapeutic use; D004311:Double-Blind Method; D004351:Drug Resistance; D004564:Electrocoagulation / Q000191:economics; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D010535:Laparoscopy / Q000191:economics; D008687:Metformin / Q000008:administration & dosage* / Q000009:adverse effects; D010352:Patient Dropouts; D010919:Placebos; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D010919:Placebos; D002996:Clomiphene; D008687:Metformin