Effect of metformin versus clomiphene citrate on ovulation and conception rate in polycystic ovarian syndrome patients

ABSTRACT

To compare the effect of metformin with clomiphene citrate on ovulation and conception rate in patients with polycystic ovarian syndrome [PCOS] one hundred infertile patients due to PCOS were selected from the Gynecology Unit III of Dow University of Health Sciences. They were divided into 2 groups each with 50 patients. Group I received metformin 500 mg per orally thrice daily for 4 months while Group II received clomiphene citrate 50 mg per orally [which was increased to 100 mg according to response] per day for 5 days following spontaneous or medroxyprogesterone acetate induced withdrawal bleeding for 4 months. Serum progesterone level was estimated on day 0, then on day 21 and finally on day120. In both the groups significant increase was found in serum progesterone level from day 0 to day 120. In group I, serum progesterone increased from 1.7ng/ml at day-0 to 11.3ng/ml at day-120. In group II, it increased from1.5 ng/ml at day-0 to7.3 ng/ml at day-120. Out of 50 patients 40 [80%] patients showed evidence of ovulation in Group I and 13 [26%] patients showed evidence of ovulation in Group II with conception rate of 67% in Group I and 16% in Group II being confirmed by urine pregnancy test. In conclusion metformin has exerted highly significant effects on the ovulation and conception rate in comparison to clomiphene citrate in PCOS infertile patients