Dietary intervention versus metformin to improve the reproductive outcome in women with polycystic ovary syndrome a prospective comparative study

ABSTRACT

To compare the clinical results and reproductive outcome in obese women with polycystic ovary syndrome [PCOS] following dietary intervention or treatment with metformin. Forty-six patients with PCOS were studied prospectively in Prince Rashed Hospital, Irbid, Jordan, between January 2003 and April 2005. The women were randomly divided into 2 groups Group 1 [n=24] was prescribed with 1200-1400 kcai/day diet [25% proteins, 25% fat, and 50% carbohydrates plus 25-30 gm of fiber per week]. Group 2 [n=22] was assigned to take 850 mg of metformin twice in a continuous manner. Both treatments continued for 6 months. Clinical and biochemical data, before and after both treatments along with the reproductive outcome were compared between the 2 groups. There were no significant differences between the 2 groups in terms of age, body mass index [BMI] and duration of infertility. Both groups had a significant improvement after treatment in the menstrual cyclicity [66.7% and 68.2% versus 12.5% and 18.2%] and significant reduction in BMI [mean of 27.4 and 27.8 versus 32.2 and 31.9], luteinizing hormone levels [7.9 +/- 1.7 and 6.9 +/- 1.8 versus 11.8 +/- 2.2 and 11.5 +/- 1.8], and androgen [testosterone, audrosteuedione, dehydroepiatidrosterone sulfate] concentration. The clinical, biochemical, and reproductive outcome including menstrual cycle pattern, ovulation, and pregnancy rates were similar in both groups after treatment. Amelioration of hyperinsulinemia and hyperandrogenemia with dietary intervention or metformin treatment improves significantly the clinical features and reproductive function in overweight PCOS women