Impact of metformin therapy in patients with polycystic ovarian syndrome.
OBJECTIVE
To determine the effect of metformin therapy in achieving menstrual regularity, pregnancy, reducing obesity and hyperinsulinemia in patients with polycystic ovarian syndrome (PCOS).


METHODS
Interventional, quasi-experimental study.


METHODS
Civil Hospital, Karachi from January 2002 to December 2003.


METHODS
Thirty patients with PCOS diagnosed on clinical symptoms, ultrasound examination and hormonal assays were selected. All patients either had raised serum fasting insulin levels or fasting blood sugar/serum fasting insulin ratio of < 4:5. Patients were then given treatment with Metformin 500 mg TID and continued for six months. The patients were called back for follow-up on monthly basis and clinical and bio-chemical variables were recorded on a proforma at 3 months and 6 months of initiating metformin treatment. The chi-square test was done and p-value determined to assess the outcome.


RESULTS
Significant effect of metformin therapy was observed at 3 months follow-up visit, 5 (16.7%) women achieved pregnancy while 20 (66.6%) women had a regular menstrual cycle (p = 0.001), and a significant reduction in weight (67.4 vs. 65.4, p = 0.001) and hyperinsulinemia (FBS: FI = 3.34 vs. 6.63, p = 0.001) was noted. After 6 months follow-up visit, 25 women were examined. Of these, 7 (28%) achieved pregnancy while 16 (64%) had regular menstrual cycle (p = 0.001) and a significant reduction in weight and hyperinsulinemia (p = 0.001).


CONCLUSIONS
Metformin is very effective in achieving menstrual regularity, ovulation and pregnancy in patients with polycystic ovarian syndrome.
Hasan
Jahan Ara
JA
Department of Obstetrics and Gynaecology, Dow University of Health Sciences and Civil Hospital, Karachi.
Memon
Ghufrana Umer
GU
D000328:Adult; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*
D007004:Hypoglycemic Agents; D008687:Metformin