Polycysctic ovarian syndrome [PCOS]; pregnancy rate following ovulation induction by clomiphene alone and with combination of metformin

ABSTRACT

To compare effectiveness of clomiphene alone and in combination with metformin in terms of conception rate in patients presenting with polycystic ovary syndrome. Randomized clinical trail. Department Obstetrics and Gynecology Unit I, Nishtar Hospital Multan, 6 months from 12th September 2009 to 11th March 2010. Primary subfertile women visiting outpatient department of Nishtar Hospital Multan with significant irregular menstrual cycle, oligo menorrhea and ultrasonographic features of polycystic ovaries were enrolled in the study. Semen samples from male partners were analyzed according to the WHO criteria. Women whose partner's semen analysis was abnormal were excluded from study. Group 'A' was given clomiphene citrate alone and second group [i.e. group B] was given colmiphene citrate and metformin. All patients were followed till six cycles for regularity of menstrual cycle [determined by history] ovulation by follicular tracking on ultrasonography, if patient [conceived], conception was confirmed by urine pregnancy test and gestational sac on ultrasonography pelvis. Final outcome was measured at six month. Information was entered in specifically designed proforma. Frequency of PCOS was 14.05%. Mean age of the patients was 31.03 +/- 0.58 vs. 29.89 +/- 0.53 years in group A and B respectively. Oligomenorrhea was present in 18[50%] vs. 18 [50%] women, amenorrhea in 7[19.4%] vs. 8[22.2%] patients and weight gain in 14[38.9%] vs. 15[41.7%] cases in group A and B respectively. Conception was achieved in 26[72.2%] vs. [18[50.0%] patients in group A and B respectively. Metformin does not seem to help in achieving higher rates of pregnancy when combined with CC as compared to CC alone