title: Comparison of Metformin and Simvastatin Administration in Women With Polycystic Ovary Syndrome Before Intra-Cytoplasmic Sperm Injection Cycle: A Prospective, Randomized, Clinical Trial Study.
abstract: BACKGROUND
  Drugs administration as a pretreatment regiment before ICSI cycle in PCOs patients could enhance the success rate.
  
  
  OBJECTIVE
  The aim of this study was to compare the effectiveness of metformin with Simvastatin in patients with polycystic ovary syndrome (PCOs) candidates for intra-cytoplasmic sperm injection (ICSI) before starting the cycle.
  
  
  METHODS
  In this prospective, double blind, randomized clinical trial the efficacy of these drugs was evaluated in 40 women with PCO syndrome (20 patients in each group; A: simvastatin and B: metformin) candidates for ICSI. In the both groups, metformin and simvastatin administrated for eight weeks before starting the ICSI cycle. Endocrine, metabolic and clinical parameters were measured before and after drug therapy; also, the results of ICSI cycle evaluated in the both groups.
  
  
  RESULTS
  Both drugs improved hirsutism score significantly, but simvastatin better than metformin (Group A, 24.5 ± 3.6 P: 0.0001 VS Group B, 22.9 ± 5.9 P: 0.003). The reduction in body mass index (BMI) was not significant in the groups. Simvastatin reduced some biochemical parameters such as FSH, LH, testosterone, total cholesterol, LDL and increased HDL level significantly, whereas metformin decreased FSH, TG, testosterone and total cholesterol significantly. Overall, respectively 35% and 30% of patients treated with metformin and Simvastatin became pregnant. There was no significant difference between the effects of these two drugs on ICSI cycle results like oocyte in meiosis2 (M2) phase (1.35 ± 1.6 vs. 2 ± 3.87, P value: 0.4) and the number of Grade A, embryo (1.2 ± 1.3 vs. 1.1 ± 1.4, P value: 0.7).
  
  
  CONCLUSIONS
  Simvastatin effectively improved hyperandrogenism signs and symptoms in patients with PCO, but this effect as a pretreatment regiment was not more expressive than metformin in ICSI cycle outcome.
authors.affiliation: Obstetrics and Gynecology Department, Infertility Fellow, Emam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Pourmatroud
authors.affiliation: Obstetrics and Gynecology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Mohammadjafari
authors.affiliation: Obstetrics and Gynecology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
authors.forename: Mandana
authors.initials: M
authors.lastname: Roozitalab
keywords: Intracytoplasmic Sperm Injection; Metformin; Polycystic Ovary Syndrome; Simvastatin