Metformin therapy in women with polycystic ovary syndrome.
OBJECTIVE
To determine the clinical, biochemical, hormonal, and ultrasonographic effects of 6 months of metformin therapy in women with polycystic ovary syndrome (PCOS) and compare with pretherapy parameters.


METHODS
50 Indian women with PCOS, 25 unmarried and 25 married, infertile women, were enrolled in this prospective clinical study. After a baseline workup, including body mass index (BMI), waist hip ratio (WHR), Ferriman Gallwey hirsutism scoring, menstrual pattern, levels of fasting insulin, lipids, oral glucose tolerance test (OGTT), serum gonadotropins, estradiol (E2), testosterone, androstenedione, sex hormone binding globulin (SHBG), and dehydroepiandrosterone sulphate (DHEAS), patients were given 1000 gm of metformin for 6 months and then reevaluated.


RESULTS
In 41 of 50 women who completed treatment, significant improvement in BMI, WHR, menstrual cyclicity (80.5%), ovulation rate (66%), and pregnancy rate (28%) was noted. Statistically significant decrease in lutenising hormone (LH) and LH/FSH ratio with an increase in follicle stimulating hormone (FSH) levels were seen. Levels of high-density lipoprotein (HDL) cholesterol (Chol) increased along with a decrease in total cholesterol. Improvement was noted in ovarian volume, stromal thickness, and number of follicles. There was no change in hirsutism, acne, levels of other sex steroid hormones, and lipids.


CONCLUSIONS
A 6-month course of metformin therapy may improve menstrual cyclicity and fertility in women with PCOS.
Aruna
J
J
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Mittal
S
S
Kumar
S
S
Misra
R
R
Dadhwal
V
V
Vimala
N
N
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000188:drug therapy; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000187:drug effects; D008687:Metformin / Q000627:therapeutic use*; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects; D010060:Ovulation / Q000187:drug effects; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D014463:Ultrasonography; D049629:Waist-Hip Ratio
D007004:Hypoglycemic Agents; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D008687:Metformin; D002784:Cholesterol