title: Metformin is a reasonable first-line treatment option for non-obese women with infertility related to anovulatory polycystic ovary syndrome--a meta-analysis of randomised trials.
abstract: BACKGROUND
  There are differences in opinion as to whether metformin should play a role in the primary treatment of anovulatory infertility for women with polycystic ovary syndrome (PCOS).
  
  
  OBJECTIVE
  The aim of this study was to ascertain the best available evidence comparing metformin versus clomiphene treatment for non-obese women with anovulatory infertility related to PCOS.
  
  
  METHODS
  Meta-analysis of available data from randomised controlled trials that examined metformin versus clomiphene for the subgroup of women in the lower body mass index (BMI) range (primarily non-obese). Primary outcomes were clinical pregnancy and live birth.
  
  
  RESULTS
  For women with BMI ≤ 30-32 kg/m2 , clinical pregnancy rates were 36.7% (52/142) for metformin and 35.7% (51/143) for clomiphene; live birth rates were 30.3% (43/142) for metformin and 30.8% (44/143) for clomiphene.
  
  
  CONCLUSIONS
  The available randomised trial data show no significant difference in effectiveness of metformin versus clomiphene as ovulation induction agents for non-obese women with anovulatory PCOS. Metformin and clomiphene are both suitable options for first-line treatment.
authors.affiliation: Fertility Plus, Green Lane Clinical Centre, Repromed Auckland, 105 Remuera Road, University of Auckland, Auckland, New Zealand. neil.johnson@adhb.govt.nz
authors.forename: Neil
authors.initials: N
authors.lastname: Johnson
mesh_terms: D000858:Anovulation / Q000188:drug therapy* / Q000209:etiology; D015992:Body Mass Index; D002996:Clomiphene / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D050498:Live Birth; D008687:Metformin / Q000627:therapeutic use*; D009765:Obesity; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D002996:Clomiphene; D008687:Metformin