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Combined metformin and clomiphene citrate versus laparoscopic ovarian diathermy for ovulation induction in clomiphene‐resistant women with polycystic ovary syndrome: A randomized controlled trial
Author(s) -
Abu Hashim Hatem,
El Lakany Naser,
Sherief Lotfy
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01383.x
Subject(s) - medicine , polycystic ovary , metformin , ovulation , miscarriage , ovulation induction , gynecology , pregnancy rate , pregnancy , anovulation , randomized controlled trial , obstetrics , insulin resistance , insulin , hormone , biology , genetics
Aim: To compare the effect of combined metformin and clomiphene citrate (CC) with laparoscopic ovarian diathermy (LOD) meant for ovulation induction in CC‐resistant women with polycystic ovary syndrome (PCOS). Methods: Two‐hundred and eighty‐two anovulatory women with CC‐resistant PCOS were selected in this randomized controlled trial. Patients ( n = 138) received combined metformin–CC for up to six cycles or underwent LOD ( n = 144) with six months follow up. The outcome measures were: ovulation rate, midcycle endometrial thickness, pregnancy and miscarriage rates. Results: Ovulation occurred in 386/576 cycles (67%) in the combined metformin–CC group and 381/558 cycles (68.2%) in LOD group without a significant difference between the groups. Resumption of regular menstruation was similar in both groups. A significant increase in midcycle endometrial thickness was observed in the combined metformin–CC group (9.2 ± 1.2 mm vs 7.6 ± 1.1 mm) ( P < 0.05). The pregnancy rate was similar in both groups (15.4% vs 17%), and there were no statistically significant differences regarding the miscarriage rate between both groups. Four twin pregnancies occurred in the metformin–CC group. No ovarian hyperstimulation occurred in either group. Conclusions: Combined metformin–CC and LOD are equally effective for inducing ovulation and achieving pregnancy in CC‐resistant PCOS patients.