Open AccessMetformin versus laparoscopic unilateral ovarian drilling in clomiphene resistant women with polycystic ovary syndrome
Author(s) -
Ibrahim Abd Elgafor El Sharkwy
Publication year - 2013
Publication title -
middle east fertility society journal/middle east fertility society journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.322
H-Index - 18
eISSN - 2090-3251
pISSN - 1110-5690
DOI - 10.1016/j.mefs.2012.12.008
Subject(s) - medicine , polycystic ovary , metformin , miscarriage , ovulation , pregnancy rate , pregnancy , randomized controlled trial , gynecology , obstetrics , urology , hormone , insulin resistance , insulin , biology , genetics
Objectives: To compare the hormonal-metabolic profiles and reproductive outcomes between women receiving metformin and women undergoing unilateral ovarian drilling in clomiphene citrate(CC) resistant patients with polycystic ovary syndrome (PCOS)Design: Non randomized controlled trial.Setting: Obstetrics and Gynecology department, Faculty of medicine, Zagazig University, Egypt.Methods: A total of 120 patients were divided into group 1(n=58) who received metformin therapy and group 2 (n=62) who underwent unilateral ovarian drilling. Hormonal-metabolic profiles changes after treatment were reported and reproductive outcomes were compared between both groups.Main outcome: FSH and LH were reduced significantly in unilateral drilling group (P=<0.001and 0.001), while there was significant improvement in testosterone level , fasting insulin, fasting glucose to insulin ratio and homeostasis model assessment index in metformin therapy group. Pregnancy and ovulation rates were higher after unilateral drilling with significant difference (P=0.048 and 0.004). No significant difference in early miscarriage rate between both groups (P=0.51).Conclusion: Unilateral LOD was associated with greater ovulation and pregnancy rates than metformin in women with PCOS who did not conceive with CC