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Two weeks of metformin improves clomiphene citrate-induced ovulation and metabolic profiles in women with polycystic ovary syndrome.
Fertil Steril. 2006 May; 85(5):1448-51.FS

Abstract

OBJECTIVE

To determine if short courses of metformin (MET) administration in patients with polycystic ovary syndrome (PCOS) would reduce fasting insulin and improve the efficacy of clomiphene citrate (CC) to induce ovulation.

DESIGN

A randomized prospective trial involving 31 subjects with PCOS and infertility.

SETTING

University-based medical center.

PATIENT(S)

Obese patients (body mass index > 29 kg/m2) with PCOS.

INTERVENTION(S)

Patients with PCOS were treated either with CC or CC+MET for 2 weeks.

MAIN OUTCOME MEASURE(S)

Ovulation as determined by serum P, serum insulin, and total and free T.

RESULT(S)

In the CC/MET group, a significant increase in sex hormone-binding globulin (SHBG) levels, a decrease in fasting insulin, and an increase in fasting glucose/fasting insulin was detected on day 21 of the cycle. Of these parameters, only SHBG levels increased significantly in the CC group. In the CC/MET group, a significant increase in day 21 progesterone occurred, with 44% of subjects ovulating in the CC+MET group as compared with 6.7% in the CC group. Five subjects in the CC+MET group and none in the CC group conceived. Total and free testosterone levels did not change significantly for either group.

CONCLUSION(S)

In obese PCOS patients, 2 weeks of MET significantly reduces serum insulin and insulin resistance and increases SHBG levels, resulting in an improved response to CC. This regimen may be beneficial in noncompliant patients or those with intolerance to the side effects of MET.

Authors+Show Affiliations

Khorram O
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, California 90502, USA. okhorram@obgyn.humc.edu
Helliwell JP
No affiliation info available
Katz S
No affiliation info available
Bonpane CM
No affiliation info available
Jaramillo L
No affiliation info available

MeSH

AdultClomipheneDrug Administration ScheduleDrug CombinationsFemaleFertility Agents, FemaleHumansHyperinsulinismHypoglycemic AgentsInfertilityInsulinMetforminObesityOvulationOvulation InductionPolycystic Ovary SyndromeSex Hormone-Binding GlobulinTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16579997

Clinical Trial Links

Metformine and CC Compared With Placebo and CC for Induction Ovulation in PCOS Patients With Insulin Resistant

Citation

Khorram, Omid, et al. "Two Weeks of Metformin Improves Clomiphene Citrate-induced Ovulation and Metabolic Profiles in Women With Polycystic Ovary Syndrome." Fertility and Sterility, vol. 85, no. 5, 2006, pp. 1448-51.
Khorram O, Helliwell JP, Katz S, et al. Two weeks of metformin improves clomiphene citrate-induced ovulation and metabolic profiles in women with polycystic ovary syndrome. Fertil Steril. 2006;85(5):1448-51.
Khorram, O., Helliwell, J. P., Katz, S., Bonpane, C. M., & Jaramillo, L. (2006). Two weeks of metformin improves clomiphene citrate-induced ovulation and metabolic profiles in women with polycystic ovary syndrome. Fertility and Sterility, 85(5), 1448-51.
Khorram O, et al. Two Weeks of Metformin Improves Clomiphene Citrate-induced Ovulation and Metabolic Profiles in Women With Polycystic Ovary Syndrome. Fertil Steril. 2006;85(5):1448-51. PubMed PMID: 16579997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two weeks of metformin improves clomiphene citrate-induced ovulation and metabolic profiles in women with polycystic ovary syndrome. AU - Khorram,Omid, AU - Helliwell,Jason P, AU - Katz,Simone, AU - Bonpane,Colleen M, AU - Jaramillo,Lorena, Y1 - 2006/03/31/ PY - 2005/06/28/received PY - 2005/10/05/revised PY - 2005/10/05/accepted PY - 2006/4/4/pubmed PY - 2006/5/24/medline PY - 2006/4/4/entrez SP - 1448 EP - 51 JF - Fertility and sterility JO - Fertil Steril VL - 85 IS - 5 N2 - OBJECTIVE: To determine if short courses of metformin (MET) administration in patients with polycystic ovary syndrome (PCOS) would reduce fasting insulin and improve the efficacy of clomiphene citrate (CC) to induce ovulation. DESIGN: A randomized prospective trial involving 31 subjects with PCOS and infertility. SETTING: University-based medical center. PATIENT(S): Obese patients (body mass index > 29 kg/m2) with PCOS. INTERVENTION(S): Patients with PCOS were treated either with CC or CC+MET for 2 weeks. MAIN OUTCOME MEASURE(S): Ovulation as determined by serum P, serum insulin, and total and free T. RESULT(S): In the CC/MET group, a significant increase in sex hormone-binding globulin (SHBG) levels, a decrease in fasting insulin, and an increase in fasting glucose/fasting insulin was detected on day 21 of the cycle. Of these parameters, only SHBG levels increased significantly in the CC group. In the CC/MET group, a significant increase in day 21 progesterone occurred, with 44% of subjects ovulating in the CC+MET group as compared with 6.7% in the CC group. Five subjects in the CC+MET group and none in the CC group conceived. Total and free testosterone levels did not change significantly for either group. CONCLUSION(S): In obese PCOS patients, 2 weeks of MET significantly reduces serum insulin and insulin resistance and increases SHBG levels, resulting in an improved response to CC. This regimen may be beneficial in noncompliant patients or those with intolerance to the side effects of MET. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/16579997/Two_weeks_of_metformin_improves_clomiphene_citrate_induced_ovulation_and_metabolic_profiles_in_women_with_polycystic_ovary_syndrome_ DB - PRIME DP - Unbound Medicine ER -