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Is the Co-administration of Metformin and Clomiphene Superior to Induce Ovulation in Infertile Patients With Poly Cystic Ovary Syndrome and Confirmed Insulin-Resistance: A Double Blind Randomized Clinical Trial

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Date 2023 Aug 4
PMID 37538230
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Abstract

Objective: This study aimed to compare the effects of clomiphene citrate (CC) combined with metformin or placebo on infertile patients with poly cystic ovary syndrome (PCOS) and insulin resistance (IR).

Materials And Methods: We included 151 infertile women with PCOS and IR in a university hospital from November 2015 to April 2022 in this prospective, double-blind, randomized, placebo-controlled trial. Patients were randomized into two groups; group A: received CC plus metformin (n = 76) and group B: received CC plus placebo (n = 75). The ovulation rate was the main outcome measure. Clinical pregnancy, ongoing pregnancy, live birth and abortion rates were secondary outcome measures.

Results: There was no remarkable difference in ovulation rate in two groups. Moreover, no significant changes were observed in clinical pregnancy, ongoing pregnancy, live birth and abortion rates between two groups. A larger proportion of women in group A suffered from side effects of metformin (9.3% versus 1.4%; p=0.064), although this was not significant.

Conclusion: In IR infertile women with PCOS, metformin pre-treatment did not increase the ovulation, clinical pregnancy and live birth rates in patients on clomiphene citrate.

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Rubin S, Bibi M, Breborowicz A, Chau P, Keltz M J Assist Reprod Genet. 2024; .

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References
1.
Moll E, van der Veen F, van Wely M . The role of metformin in polycystic ovary syndrome: a systematic review. Hum Reprod Update. 2007; 13(6):527-37. DOI: 10.1093/humupd/dmm026. View

2.
Nestler J, Jakubowicz D, Evans W, Pasquali R . Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome. N Engl J Med. 1998; 338(26):1876-80. DOI: 10.1056/NEJM199806253382603. View

3.
Leanza V, Coco L, Grasso F, Leanza G, Zarbo G, Palumbo M . Ovulation induction with clomiphene citrate and metformin in women with polycystic ovary syndrome. Minerva Ginecol. 2014; 66(3):299-301. View

4.
. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004; 81(1):19-25. DOI: 10.1016/j.fertnstert.2003.10.004. View

5.
Moll E, Bossuyt P, Korevaar J, Lambalk C, van der Veen F . Effect of clomifene citrate plus metformin and clomifene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome: randomised double blind clinical trial. BMJ. 2006; 332(7556):1485. PMC: 1482338. DOI: 10.1136/bmj.38867.631551.55. View