Metformin administration and laparoscopic ovarian drilling improve ovarian response to clomiphene citrate (CC) in oligo-anovulatory CC-resistant women with polycystic ovary syndrome.
OBJECTIVE
To compare the efficacy of clomiphene citrate (CC) administration for ovulation induction in CC-resistant oligo-ovulatory women with polycystic ovary syndrome (PCOS) after metformin treatment or laparoscopic ovarian drilling (LOD). Design Prospective controlled study.


METHODS
Twenty-eight overweight oligo-amenorrhoeic women with PCOS who were still anovulatory after metformin administration (group A, n = 8) or LOD (group B, n = 20).


METHODS
Treatment with CC 150 mg/day for 5 days from the third to the seventh day of a progesterone-induced uterine bleeding for 6 months.


METHODS
The ovulation, pregnancy, abortion and live-birth rates were evaluated in each group.


RESULTS
The subjects of groups A and B were studied for a total of 36 and 74 cycles, respectively. At the end of the study, no differences in ovulation [11/36 (30.6%) vs. 23/74 (31.1%); P = 0.96], pregnancy [6/36 (16.7%) vs. 12/74 (16.2%); P = 0.95], abortion [2/6 (33.3%) vs. 5/12 (41.7%); P = 1.00] and the live-birth [4/6 (66.7%) vs. 7/12 (58.3%); P = 1.00] rates were observed between groups A and B.


CONCLUSIONS
Metformin administration as well as LOD improves the effectiveness of CC for ovulation induction in overweight infertile CC-resistant women with PCOS.
Palomba
Stefano
S
Department of Obstetrics and Gynaecology, University Magna Graecia of Catanzaro, Italy. stefanopalomba@tin.it
Orio
Francesco
F
Falbo
Angela
A
Russo
Tiziana
T
Caterina
Grande
G
Manguso
Francesco
F
Tolino
Achille
A
Colao
Annamaria
A
Zullo
Fulvio
F
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D010535:Laparoscopy; D008687:Metformin / Q000627:therapeutic use*; D010053:Ovary / Q000601:surgery*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin