POLYCYSTIC OVARIAN DISEASE

IMPACT OF METFORMIN ON FERTILITY IN WOMEN

Abstract

Objectives: To determine the role of metformin in correcting the irregularity of
menstrual periods and infertility due to PCO. Study Design: Descriptive observational study.
Setting: Gynecology Department of PUMHS Nawabshah. Period: 4th February 2010 up to
November 2011. Patients and methods: Total 329 patients had selected in this series, based on
presence of PCO on ultrasound with 2 or extra following criteria like oligomenorrhea, hirsutism,
hyperandrogenism and reversed FSH: LH ratio. Other endocrinal reasons of female infertility
as Cushing syndrome, congenital adrenal hyperplasia, hyperprolectinemia and cases thyroid
disorder had excluded. After detailed history, Metformin was started with dose of 250mg
once a day initially then gradually adjusted to 500mg TD. Weight decreased was encouraged
with diet and the exercise. Cases assessed after six months for checking regularity of their
menstrual cycle, fertility and the BMI change. Cases those not be success to conceive following
6 months, than the ongoing criteria of clomiphene. Women those failed to conceive after
uses of clomiphene citrate, than metformin alone was sustained and fertility had re evaluated
on end of 1 year. Results: 329 cases had selected. Commonest menstrual irregularity was
oligomenorrhea with hypo menorrhea which is seen in 46% of patients. After six months of
metformin treatment 82% cases assessed improvement of menstrual cycle, while 13% still have
oligomenorrhea. Results found significant (P<0.001) .BMI of all study patients was compared
prior and then treatment and significant results were found (P <0.001). After six months for
fertility analysis, complete data was available from 117 patients only. Overall fertility rate was
91.1%. Conclusion: Metformin is successful treatment of cases having PCOS.