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Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome.
Fertil Steril. 2009 Jun; 91(6):2557-67.FS

Abstract

OBJECTIVE

To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors.

DESIGN

Prospective controlled study.

SETTING

Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy.

PATIENT(S)

Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age.

INTERVENTION(S)

Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day).

MAIN OUTCOME MEASURE(S)

Baseline clinical and biochemical parameters categorized according to interventions response.

RESULT(S)

The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC.

CONCLUSION(S)

Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University Magna Graecia, Catanzaro, Italy. stefanopalomba@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

18440534

Citation

Palomba, Stefano, et al. "Efficacy Predictors for Metformin and Clomiphene Citrate Treatment in Anovulatory Infertile Patients With Polycystic Ovary Syndrome." Fertility and Sterility, vol. 91, no. 6, 2009, pp. 2557-67.
Palomba S, Falbo A, Orio F, et al. Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome. Fertil Steril. 2009;91(6):2557-67.
Palomba, S., Falbo, A., Orio, F., Tolino, A., & Zullo, F. (2009). Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome. Fertility and Sterility, 91(6), 2557-67. https://doi.org/10.1016/j.fertnstert.2008.03.011
Palomba S, et al. Efficacy Predictors for Metformin and Clomiphene Citrate Treatment in Anovulatory Infertile Patients With Polycystic Ovary Syndrome. Fertil Steril. 2009;91(6):2557-67. PubMed PMID: 18440534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome. AU - Palomba,Stefano, AU - Falbo,Angela, AU - Orio,Francesco,Jr AU - Tolino,Achille, AU - Zullo,Fulvio, Y1 - 2008/04/28/ PY - 2008/01/11/received PY - 2008/02/23/revised PY - 2008/02/23/accepted PY - 2008/4/29/pubmed PY - 2009/7/9/medline PY - 2008/4/29/entrez SP - 2557 EP - 67 JF - Fertility and sterility JO - Fertil Steril VL - 91 IS - 6 N2 - OBJECTIVE: To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors. DESIGN: Prospective controlled study. SETTING: Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy. PATIENT(S): Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age. INTERVENTION(S): Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day). MAIN OUTCOME MEASURE(S): Baseline clinical and biochemical parameters categorized according to interventions response. RESULT(S): The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC. CONCLUSION(S): Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/18440534/Efficacy_predictors_for_metformin_and_clomiphene_citrate_treatment_in_anovulatory_infertile_patients_with_polycystic_ovary_syndrome_ DB - PRIME DP - Unbound Medicine ER -