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Metformin effects on clomifene-induced ovulation in the polycystic ovary syndrome.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common, complex endocrine disorder for women on reproductive age. A high incidence of ovulation failure is observed in PCO women and perhaps linked to insulin resistance related to metabolic features In the last few years some studies assessed hyperinsulinimea and insulin resistance attenuation effects, by insulin sensitizing agents such as metformin, in PCOS women suggesting potential scope for these drugs in CC ovulation induction quality improvement.

AIM

Our prospective study aim is to compare the effectiveness of clomifene citrate plus metformin and clomifene citrate plus placebo in women with newly diagnosed polycystic ovary syndrome.

METHODS

From February 24 to September 29 (2007), PCOS was explored on women attending the Department of Obstetrics & Gynaecology sterility consultation unit (CHU Hedi Chaker-Sfax) according to the Rotterdam 2003 diagnostic criteria. PCOS patients were randomized to receive, in addition to clomifene citrate treatment, placebo or metformin 850 mg two times a day all ovulatory cycle for three trials maximum. Ovulation detection was done by the E2 serum measurements and ovarian transvaginal ultrasonography' evolution controlling on 7th, 11th and 13th day of the cycle.

RESULTS

Within 7 months, 32 PCOS women were recruited in the study and equally allocated to the two groups. Baseline characteristics were similar in metformin group and placebo one. Ovulation was characterized by the presence of at least one mature follicle (> 16 mm), a circulating estradiol concentration in the edge of 150-250 pg and accessory an endometrial depth > 8 mm. The ovulation rate in the metformin group was 62.5% compared with 37.5% in the placebo group, a non-statistically significant (small study population) but important difference (1.66 times). Analyses show a higher mature follicle number and estradiol concentration in metformin group than in the placebo one. Metformin effect was, in our study, his only insulinosensitizer property consequence far away a 'making thinner' or Hyperandrogenism reducing ones.

CONCLUSION

The ovulatory response to clomifene can be increased in polycystic ovary syndrome women by decreasing insulin secretion with metformin.

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  • Authors+Show Affiliations

    ,

    Department of Obstetrics & Gynaecology, CHU Hedi Chaker-Sfax.

    , , , , , , , , ,

    Source

    La Tunisie medicale 87:1 2009 Jan pg 43-9

    MeSH

    Adult
    Clomiphene
    Female
    Fertility Agents, Female
    Humans
    Hypoglycemic Agents
    Metformin
    Ovulation Induction
    Polycystic Ovary Syndrome
    Prospective Studies

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    19522426

    Citation

    Ben Ayed, B, et al. "Metformin Effects On Clomifene-induced Ovulation in the Polycystic Ovary Syndrome." La Tunisie Medicale, vol. 87, no. 1, 2009, pp. 43-9.
    Ben Ayed B, Dammak dit Mlik S, Ben Arab H, et al. Metformin effects on clomifene-induced ovulation in the polycystic ovary syndrome. Tunis Med. 2009;87(1):43-9.
    Ben Ayed, B., Dammak dit Mlik, S., Ben Arab, H., Trabelssi, H., Chahtour, H., Mathlouthi, N., ... Guermazi, M. (2009). Metformin effects on clomifene-induced ovulation in the polycystic ovary syndrome. La Tunisie Medicale, 87(1), pp. 43-9.
    Ben Ayed B, et al. Metformin Effects On Clomifene-induced Ovulation in the Polycystic Ovary Syndrome. Tunis Med. 2009;87(1):43-9. PubMed PMID: 19522426.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Metformin effects on clomifene-induced ovulation in the polycystic ovary syndrome. AU - Ben Ayed,B, AU - Dammak dit Mlik,S, AU - Ben Arab,H, AU - Trabelssi,H, AU - Chahtour,H, AU - Mathlouthi,N, AU - Dhuib,M, AU - Kassis,M, AU - Saiidane,D, AU - Trabelssi,K, AU - Guermazi,M, PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2009/8/6/medline SP - 43 EP - 9 JF - La Tunisie medicale JO - Tunis Med VL - 87 IS - 1 N2 - BACKGROUND: Polycystic ovary syndrome (PCOS) is a common, complex endocrine disorder for women on reproductive age. A high incidence of ovulation failure is observed in PCO women and perhaps linked to insulin resistance related to metabolic features In the last few years some studies assessed hyperinsulinimea and insulin resistance attenuation effects, by insulin sensitizing agents such as metformin, in PCOS women suggesting potential scope for these drugs in CC ovulation induction quality improvement. AIM: Our prospective study aim is to compare the effectiveness of clomifene citrate plus metformin and clomifene citrate plus placebo in women with newly diagnosed polycystic ovary syndrome. METHODS: From February 24 to September 29 (2007), PCOS was explored on women attending the Department of Obstetrics & Gynaecology sterility consultation unit (CHU Hedi Chaker-Sfax) according to the Rotterdam 2003 diagnostic criteria. PCOS patients were randomized to receive, in addition to clomifene citrate treatment, placebo or metformin 850 mg two times a day all ovulatory cycle for three trials maximum. Ovulation detection was done by the E2 serum measurements and ovarian transvaginal ultrasonography' evolution controlling on 7th, 11th and 13th day of the cycle. RESULTS: Within 7 months, 32 PCOS women were recruited in the study and equally allocated to the two groups. Baseline characteristics were similar in metformin group and placebo one. Ovulation was characterized by the presence of at least one mature follicle (> 16 mm), a circulating estradiol concentration in the edge of 150-250 pg and accessory an endometrial depth > 8 mm. The ovulation rate in the metformin group was 62.5% compared with 37.5% in the placebo group, a non-statistically significant (small study population) but important difference (1.66 times). Analyses show a higher mature follicle number and estradiol concentration in metformin group than in the placebo one. Metformin effect was, in our study, his only insulinosensitizer property consequence far away a 'making thinner' or Hyperandrogenism reducing ones. CONCLUSION: The ovulatory response to clomifene can be increased in polycystic ovary syndrome women by decreasing insulin secretion with metformin. SN - 0041-4131 UR - https://www.unboundmedicine.com/medline/citation/19522426/Metformin_effects_on_clomifene_induced_ovulation_in_the_polycystic_ovary_syndrome_ L2 - http://www.latunisiemedicale.com/article-medicale-tunisie.php?article=1037 DB - PRIME DP - Unbound Medicine ER -