POLYCYSCTIC OVARIAN SYNDROME (PCOS);

PREGNANCY RATE FOLLOWING OVULATION INDUCTION BY CLOMIPHENE ALONE AND WITH COMBINATION OF METFORMIN

Abstract

Objective: To compare effectiveness of clomiphene alone and in combination
with metformin in terms of conception rate in patients presenting with polycystic ovary syndrome.
Study Design: Randomized clinical trail. Place and duration of study: Department Obstetrics
and Gynecology Unit I, Nishtar Hospital Multan, 6 months from 12th September 2009 to 11th
March 2010. Methodology: 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. Results: 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. Conclusions: Metformin does not seem to help in achieving higher rates of
pregnancy when combined with CC as compared to CC alone.