PCOSMIC: a multi-centre randomized trial in women with PolyCystic Ovary Syndrome evaluating Metformin for Infertility with Clomiphene  

Oleh:

Johnson, N.P. ; Stewart, A.W. ; Falkiner, J.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Human Reproduction vol. 25 no. 07 (Jul. 2010), page 1675-1683.
Topik: polycystic ovary syndrome; anovulation; metformin; clomiphene citrate; randomized controlled trial

Ketersediaan

Perpustakaan FK Nomor Panggil: H07.K.2010.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

BACKGROUND Ovulation induction treatment with metformin, either alone or in combination with clomiphene citrate (CC), remains controversial even though previous randomized trials have examined this. METHODS A double blinded multi-centre randomized trial was undertaken including 171 women with anovulatory or oligo-ovulatory polycystic ovary syndrome. Women with high body mass index (BMI) > 32 kg/m2 received placebo (‘standard care’) or metformin; women with BMI = 32 kg/m2 received CC (‘standard care’), metformin or both. Treatment continued for 6 months or until pregnancy was confirmed. Primary outcomes were clinical pregnancy and live birth. RESULTS For women with BMI > 32 kg/m2, clinical pregnancy and live birth rates were 22% (7/32) and 16% (5/32) with metformin, 15% (5/33) and 6% (2/33) with placebo. For women with BMI = 32 kg/m2, clinical pregnancy and live birth rates were 40% (14/35) and 29% (10/35) with metformin, 39% (14/36) and 36% (13/36) with CC, 54% (19/35) and 43% (15/35) with combination metformin plus CC. CONCLUSIONS There is no evidence that adding metformin to ‘standard care’ is beneficial. Pregnancy and live birth rates are low in women with BMI > 32 kg/m2 whatever treatment is used, with no evidence of benefit of metformin over placebo. For women with BMI = 32 kg/m2 there is no evidence of significant differences in outcomes whether treated with metformin, CC or both.

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