title: Metformin treatment in different phenotypes of polycystic ovary syndrome.
abstract: BACKGROUND
  The aim of this study was to evaluate the effectiveness of Metformin on ovulation and eventual clinical pregnancy in different phenotypes of polycystic ovary syndrome (PCOS).
  
  
  METHODS
  A total of 359 subjects who had proven PCOS according to Rotterdam criteria were prospectively selected. Patients' PCOS phenotypes were determined and recorded. All patients were younger than 35 years. Clinical and biochemical assays in all patients were initially obtained. Then patients were divided into two separate groups. One group received both 1,500 mg of Metformin and 1 mg of folic acid per day and the other group received only 1 mg of folic acid for a total of 2 months. Subsequently, all patients underwent ovulation stimulation with 5 mg of Letrozole per day for 5 days followed by an intra-uterine insemination. Finally, ovulation and pregnancy rates were evaluated for all four PCOS phenotypes. Effect of Metformin therapy was evaluated for each group and each phenotype.
  
  
  RESULTS
  The pregnancy rate in Metformin and non-Metformin groups were, respectively, as follows: in phenotype A (39.2 vs. 33.7 %, p = 0.270), phenotype B (43.8 vs. 20 %, p = 0.210), phenotype C (44 vs. 20 %, p = 0.064), and phenotype D (36.5 vs. 28.6 %, p = 0.279).
  
  
  CONCLUSIONS
  Although there was a little improvement in ovulation and pregnancy rates among patients with B and C phenotypes, there was not a statistically significant difference between the two groups. Based on our study, Metformin therapy does not change the ovulation and pregnancy rate.
authors.affiliation: Infertility Department, Shariati Hospital, Tehran University of Medical Sciences, North Kargar St, Near Gisha Bridge, Tehran, Iran.
authors.forename: Marzieh Agha
authors.initials: MA
authors.lastname: Hosseini
authors.forename: Ashraf
authors.initials: A
authors.lastname: Alleyassin
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Sarvi
authors.forename: Leila
authors.initials: L
authors.lastname: Safdarian
authors.forename: Abas
authors.initials: A
authors.lastname: Kokab
authors.forename: Mehran
authors.initials: M
authors.lastname: Fanisalek
mesh_terms: D000328:Adult; D005260:Female; D005492:Folic Acid / Q000494:pharmacology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007315:Insemination, Artificial; D008687:Metformin / Q000494:pharmacology*; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D014803:Vitamin B Complex / Q000494:pharmacology; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D014803:Vitamin B Complex; D008687:Metformin; D005492:Folic Acid