Objectives: To know the incidence and characters of insulin resistance (lR) in polycystic ovaries (PCO) patients, and
the efficacy of metformin treatment for induction of ovulation compared to clomiphene citrate (CC); also the effect of
.metformin on the clinical, biochemical and hormonal features of the patient would be evaluated.
Design: A prospective, blind, controlled study.
Setting: Outpatient infertility clinic, Benha University Hospital.
Subjects: Sixty infertile PCO patients.
Methods: The body mass index (BMI), the hirsutism and the acne scores, the fasting blood glucose, the fasting serum
insulin and serum testosterone levels were measured for every patient. A ratio of fasting blood glucose to fasting serum
insulin (G/I) of less than 4.5 mgllO-4 untis was considered IR. Insulin resistant patients were randomly divided into
three groups and treated for three cycles. The first group was treated with CC + mctforrnin, the second with placebo +
metformin and the third with CC + placebo.
Main outcome measures: The ovulation and pregnancy rates with metformin treatment compared to CC.
Results: IR is present in about 86.6% of PCO patients. They are characterized by having higher BML fasting serum
insulin and serum testosterone levIes, than non IR patients. Treatment with CC + mctformin results in higher ovulation
and pregnancy rates compared to that obtained with CC alone.
Conclusions: IR must be diagnosed in PCO patients. Induction of ovulation with CC + mctforrnin results in higher
ovulation and pregnancy rates. In contrast to ce, the longer the duration of metformin treatment, the better arc the
results.