Effects of metformin and clomiphene citrate on ovarian vascularity in patients with polycystic ovary syndrome.
OBJECTIVE
To evaluate the effects of metformin and of clomiphene citrate (CC) on the ovarian blood perfusion and on perifollicular and peri-corpus luteum (CL) vascularity in anovulatory women with polycystic ovary syndrome (PCOS).


METHODS
Prospective cohort study.


METHODS
University "Magna Graecia" of Catanzaro.


METHODS
Forty anovulatory nonobese patients with PCOS who ovulated under treatment with metformin (850 mg twice daily) plus placebo (metformin group) and 38 under placebo plus CC (150 mg for 5 days; CC group). Another 30 healthy normal cycled women (control group).


METHODS
Serial transvaginal ultrasonographic examinations.


METHODS
Ovary artery blood flow impedance, dimensions, and vascularization of the dominant follicle and of the CL.


RESULTS
No difference was observed in all parameters in metformin ovulating cycles in comparison with healthy controls. In CC ovulating cycles, ovarian artery impedance, and perifollicular and peri-CL vascularization the results were significantly different from the metformin and control groups. After grouping the stimulated cycles for reproductive outcomes, perifollicular vascularization alone ended up being significantly lower only in CC-stimulated cycles with unfavorable outcome.


CONCLUSIONS
In patients with PCOS who ovulate under treatment with metformin, the ovarian blood flows are similar to those observed in healthy women, whereas CC administration reduces the ovarian and, specifically, the perifollicular vascularization.
Palomba
Stefano
S
Department of Obstetrics & Gynecology, University Magna Graecia, Catanzaro, Italy. stefanopalomba@tin.it <stefanopalomba@tin.it>
Orio
Francesco
F
Falbo
Angela
A
Russo
Tiziana
T
Tolino
Achille
A
Zullo
Fulvio
F
D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D002996:Clomiphene / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D008687:Metformin / Q000008:administration & dosage*; D010053:Ovary / Q000098:blood supply* / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D002996:Clomiphene; D008687:Metformin