PCOS

COMPARISON BETWEEN PIOGLITAZONE AND METFORMIN FOR OVULATION IN PATIENTS

Abstract

Objectives: The objective is to compare the efficacy of Pioglitazone and
Metformin for ovulation in patients of polycystic ovarian syndrome. Study Design: Randomized
control trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period:
January 2017 to June 2017. Methodology: Total number of 66 patients was recruited for this
study. These patients were admitted through or outpatient department. Group A and Group B,
33 patients each. In Group-A patients received metformin while in Group B pioglitazone was
administered. Sample size was calculated using the reference study by Chaudhry I et al (9)
using sample size calculator for two proportions (power of study 80% and confidence interval
95% where prevalence (P1) was 52.17% and (P2) 75%). In group-A patients, Metformin with
dose of 1500 mg per day in three divided doses were given for 6 months. In group B patients,
Pioglitazone 15mg was administered for 6 months. At the end of 6 months, all the patients were
evaluated for efficacy. Results: Total no. of 66 patients was included. The mean age and BMI
of the patients was 29.35±4.01 years and 29.74±2.75 kg/m2 respectively. The age distribution
noted as 66.7% (n=44) patients between 18-30 years and 33.3% (n=22) between 31-37 years.
BMI distribution observed as 45.5% (n=30) patients between 24-29 kg/m2 and 54.5% (n=36)
patients between 30-34 kg/m2. These 100% (n=66) patients were divided into 2 groups equally,
33 in each, i.e. group A and group B. The mean age and BMI of the patients of group A
was 29.42±4.32 years and 29.87±2.58 kg/m2 respectively, while the mean age and BMI of
the patients of group B was 29.27±3.75 years and 29.60±2.94 kg/m2 respectively. Ovulation
was noted as 42.4% (n=14) and 45.5% (=15) for groups A and B respectively. No association
was found between efficacy and ovulation (p=0.849). Efficacy was notes as 69.7% (n=23) and
72.7% (n=24) for group A and group B respectively. No difference was found between efficacy
and groups i.e. between pioglitazone and metformin for ovulation in patients of polycystic ovary
syndrome (p=0.786). Similarly, no association was found between efficacy with age (p=0.442)
and BMI (p=0.728), after applying the chi-square. Conclusion: This study concludes that
Pioglitazone is as much effective as metformin for ovulation induction in women with PCOS.