 Metformin pre-treatment combats clomiphene resistance
Metformin pre-treatment combats clomiphene resistance
Source: Human Reproduction 2003; 18: 299-304
Anovulatory, clomiphene-resistant women with polycystic ovary syndrome may benefit from pre-treatment with metformin.
Sequential treatment with metformin and clomiphene citrate is an effective approach to restoring fertility in clomiphene-resistant women with polycystic ovary syndrome (PCOS), say researchers.
Up to 25 percent of anovulatory women with PCOS exhibit resistance to ovulation induction with clomiphene citrate, observe Susan Shanti George (Christian Medical College, Tamil Nadu, India) and co-workers. Given that such resistance is linked to obesity and insulin resistance, the team postulated that pre-treatment with metformin, which has both insulin-sensitizing and weight-reducing properties, could improve responses to clomiphene citrate.
Their randomized study involved 60 clomiphene-resistant women with PCOS, who were treated with metformin for 6 months followed by ovulation induction with clomiphene citrate, or received ovulation induction with human menopausal gonadotropin (hMG) only.
The pregnancy rate was 17 percent in the metformin-clomiphene group, and 23 percent in the hMG group, a difference that was not statistically significant. In addition the metformin-clomiphene group showed improvements in menstrual function, ovulation rates, and insulin levels.
"On balance, metformin-clomiphene therapy represents a viable interim option for young clomiphene-resistant PCOS women, and is also a valuable treatment alternative in developing countries where patients have financial constraints that preclude ovulation induction with hMG," the team concludes.
Posted: 26 February 2003
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