title: An assessment of lifestyle modification versus medical treatment with clomiphene citrate, metformin, and clomiphene citrate-metformin in patients with polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare the effect of clomiphene citrate, metformin, and lifestyle modification on treatment of patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Prospective randomized double-blind study.
  
  
  METHODS
  University-based infertility clinic and research center.
  
  
  METHODS
  Three hundred forty-three overweight infertile women with PCOS.
  
  
  METHODS
  The participating women were assigned to four groups: clomiphene (n = 90), metformin (n = 90), clomiphene + metformin (n = 88), and lifestyle modification (n = 75). The patients in each group received standardized dietary and exercise advice from a dietitian.
  
  
  METHODS
  The primary outcome variables were change in menstrual cycle, waist circumference measurements, endocrine parameters, and lipid profile. The main secondary outcome variable was clinical pregnancy rate.
  
  
  RESULTS
  The clinical pregnancy rate was 12.2% in clomiphene group, 14.4% in metformin group, 14.8% in clomiphene + metformin group, and 20% in lifestyle modification group. Lifestyle modification group achieved a significant reduction in waist circumference, total androgen, and lipid profile.
  
  
  CONCLUSIONS
  Lifestyle modification improves the lipid profile in PCOS patients. Therefore, lifestyle modification may be used as the first line of ovulation induction in PCOS patients.
authors.affiliation: Research and Clinical Center for Infertility, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran. nikanresearch@gmail.com
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Karimzadeh
authors.forename: Mojgan
authors.initials: M
authors.lastname: Javedani
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008019:Life Style; D008687:Metformin / Q000008:administration & dosage*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002996:Clomiphene; D008687:Metformin