title: Randomized controlled trial of different doses of metformin for ovulation induction in infertile women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare the efficacy of 1000 mg and 1700 mg of metformin on ovulation induction in polycystic ovary syndrome (PCOS) women.
  
  
  METHODS
  A randomized controlled trial was conducted at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand of 60 PCOS women diagnosed by Rotterdam criteria. Group A (30 women) and B (30 women) received 1000 mg and 1700 mg/day of metformin, respectively. Clomiphen citrate 50-150 mg per day for 5 days was added, if no dominant follicle developed. The main outcome measures were ovulation and pregnancy rates, fasting insulin (FI), testosterone (T), androstenedione (ADD) and DHEAS before and 4 weeks after metformin.
  
  
  RESULTS
  The ovulation rate did not differ between the groups (84.8% vs 87.7% between groups A and B, P=NS). Most of the women developed one follicle (91% in group A and 88.2% in group B, P=NS). The pregnancy rate in group A (46.4% per woman and 12.4% per ovulatory cycle) did not differ from that in group B (51.9% per woman and 13.2% per ovulatory cycle, P=NS). With regard to dosages, the ovulation rate in PCOS women without insulin resistance (IR) was significantly higher than those with IR. FI, T and ADD were significantly decreased after 4 weeks of metformin in both groups.
  
  
  CONCLUSIONS
  1000 mg of metformin had as high efficacy as 1700 mg on induction of ovulation and pregnancy in PCOS women.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. raswt@mahidol.ac.th
authors.forename: Sawaek
authors.initials: S
authors.lastname: Weerakiet
authors.forename: Areepan
authors.initials: A
authors.lastname: Sophonsritsuk
authors.forename: Srithean
authors.initials: S
authors.lastname: Lertvikool
authors.forename: Chonthicha
authors.initials: C
authors.lastname: Satirapot
authors.forename: Supatra
authors.initials: S
authors.lastname: Leelaphiwat
authors.forename: Rattiya
authors.initials: R
authors.lastname: Jultanmas
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D007333:Insulin Resistance; D008687:Metformin / Q000008:administration & dosage* / Q000627:therapeutic use; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin