The effect of body mass index on the response of the use of metformin, to augment the induction of ovulation, in infertile patient with polycystic ovary syndrome

Abstract EN

Objective : To compare the effectiveness of metformin alone with a combination of clomiphene citrate and metformin in infertile obese and non obese patients with polycystic ovary syndromes.

(PCOS).

Methods : A double-blind placebo-controlled study was done on 20 obese Egyptian patients and 20 non obese Yamnie patients with PCOS women failed to ovulate under clomiphene therapy.

Every group was divided into two groups each one consisted of 10 patients.

In the first phase of the study each sub-group were received metformin 50mg three times daily or clomiphene citrate 50mg for 5 consecutive days for 3 mounts.

On the second phase each women ether received metformin in combination with clomid or placebo for another three months.

Folliculometry was done and ovulation was triggered with HCG when mature follicles were seen on ultrasound examination.

Ovarian responses, evidence of ovulation and pregnancy rate where assessed Results : Metformin treatment was well tolerated and accompanied by marked drop in insulin response to oral glucose tolerance test in both obese and lean women.

It restored eumenorrhea and ovulation but did not reduce body mass index.

In women with anovulatory infertility caused by hyperandrogenism and insulin resistance clomiphene citrate treatment often fails to results in pregnancy.

The pregnancy rate increased significantly when combine metformin and clomid were given to those women with more pregnancy in the group with low body mass index.

Conclusion : Body mass index did not alter the enhancement effect of adding metformin treatment to.clomiphene citrate for induction of ovulation in patients with PCOS, But it was found to have an effect on pregnancy rate with a significant increase in number of pregnancy among women with low body mass index.