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Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial.
Fertil Steril. 2009 Feb; 91(2):514-21.FS

Abstract

OBJECTIVE

To determine the first-line medication to be used in anovulatory patients with polycystic ovary syndrome (PCOS) for ovulation induction and pregnancy achievement.

DESIGN

Randomized controlled trial.

SETTING

Infertility unit of a public hospital.

PATIENT(S)

One hundred fifteen newly diagnosed patients with PCOS based on ESHRE/ASRM criteria.

INTERVENTION(S)

These patients were assigned to three groups: group 1 (38 patients) received 500 mg of metformin three times a day; group 2 (39 patients) received clomiphene citrate (CC) at an incremental dose; group 3 (38 patients) received both medications.

MAIN OUTCOME MEASURE(S)

Rates of ovulation, pregnancy (PR), and live birth.

RESULT(S)

The ovulation rate was 23.7% in the metformin group, 59% in the CC group, and 68.4% in the combination treatment group. This was translated into a similar PR and live birth rate, which were higher in the CC and combination groups compared to the metformin group (PR: 7.9%, 15.4%, and 21.1%; live birth rate: 7.9%, 15.4%, and 18.4% in metformin, CC, and combination treatment groups, respectively), although statistically the differences were not significant. There were no multiple pregnancies and the rate of spontaneous first trimester loss was similar to the general population.

CONCLUSION(S)

Clomiphene citrate should be the first-line treatment for ovulation induction in anovulatory patients with PCOS.

Authors+Show Affiliations

Department of Obstetric and Gynaecology, Alor Setar Hospital, Kedah, Malaysia. murizahz@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18321486

Citation

Zain, Murizah Mohd, et al. "Comparison of Clomiphene Citrate, Metformin, or the Combination of Both for First-line Ovulation Induction, Achievement of Pregnancy, and Live Birth in Asian Women With Polycystic Ovary Syndrome: a Randomized Controlled Trial." Fertility and Sterility, vol. 91, no. 2, 2009, pp. 514-21.
Zain MM, Jamaluddin R, Ibrahim A, et al. Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial. Fertil Steril. 2009;91(2):514-21.
Zain, M. M., Jamaluddin, R., Ibrahim, A., & Norman, R. J. (2009). Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial. Fertility and Sterility, 91(2), 514-21. https://doi.org/10.1016/j.fertnstert.2007.12.002
Zain MM, et al. Comparison of Clomiphene Citrate, Metformin, or the Combination of Both for First-line Ovulation Induction, Achievement of Pregnancy, and Live Birth in Asian Women With Polycystic Ovary Syndrome: a Randomized Controlled Trial. Fertil Steril. 2009;91(2):514-21. PubMed PMID: 18321486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial. AU - Zain,Murizah Mohd, AU - Jamaluddin,Ridzuan, AU - Ibrahim,Adibah, AU - Norman,Robert J, Y1 - 2008/03/05/ PY - 2007/10/05/received PY - 2007/12/07/revised PY - 2007/12/07/accepted PY - 2008/3/7/pubmed PY - 2009/2/21/medline PY - 2008/3/7/entrez SP - 514 EP - 21 JF - Fertility and sterility JO - Fertil Steril VL - 91 IS - 2 N2 - OBJECTIVE: To determine the first-line medication to be used in anovulatory patients with polycystic ovary syndrome (PCOS) for ovulation induction and pregnancy achievement. DESIGN: Randomized controlled trial. SETTING: Infertility unit of a public hospital. PATIENT(S): One hundred fifteen newly diagnosed patients with PCOS based on ESHRE/ASRM criteria. INTERVENTION(S): These patients were assigned to three groups: group 1 (38 patients) received 500 mg of metformin three times a day; group 2 (39 patients) received clomiphene citrate (CC) at an incremental dose; group 3 (38 patients) received both medications. MAIN OUTCOME MEASURE(S): Rates of ovulation, pregnancy (PR), and live birth. RESULT(S): The ovulation rate was 23.7% in the metformin group, 59% in the CC group, and 68.4% in the combination treatment group. This was translated into a similar PR and live birth rate, which were higher in the CC and combination groups compared to the metformin group (PR: 7.9%, 15.4%, and 21.1%; live birth rate: 7.9%, 15.4%, and 18.4% in metformin, CC, and combination treatment groups, respectively), although statistically the differences were not significant. There were no multiple pregnancies and the rate of spontaneous first trimester loss was similar to the general population. CONCLUSION(S): Clomiphene citrate should be the first-line treatment for ovulation induction in anovulatory patients with PCOS. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/18321486/Comparison_of_clomiphene_citrate_metformin_or_the_combination_of_both_for_first_line_ovulation_induction_achievement_of_pregnancy_and_live_birth_in_Asian_women_with_polycystic_ovary_syndrome:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(07)04184-2 DB - PRIME DP - Unbound Medicine ER -