Objective: To compare the efficacy of metformin montherapy in improvement of the clinical and biochemical parameters, ovulation and pregnancy
rates in obese and non obese patients with polycystic ovary syndrome.
Patients and method:We examined 110 PCOS and 36 controls aged 19-
34 years old, body mass index (BMI), A prospective comparative study in
Minia University infertility clinic. One hundered infertile women were diagnosed as clomiphene citrate resistant polycystic ovary syndrome at the
period starting from November 2009 to August 2010.. The patients were
divided into 2 groups .Group (O); included 50 patients with BMI ≥30 kg/
m2. Group( N); included 50 patients with BMI ≤30 kg/m2. Both groups
received metformin 850 mg tablet twice daily for 12 weeks. The primary
outcomes were the ovulation rate, the degree of menstrual regularity , the
change of the patients' clinical and biochemical profile after three months
of metformin treatment; including the changes in LH/FSH ratio.The secondary outcome was the pregnancy rate.
Results:There was a statistically significant improvement as regards preand post-treatment concerning regularity of the cycle (p < 0.0001) , acne
(p < 0.001) and LH: FSH ratio (p= 0.015) and no statistically significant improvement as regard hirustism between both groups .In addition,there was
a statistically significant improvement as regards pre- and post-treatment
concerning regularity of the cycle (p=0.0001 & 0.0002) , acne (p=0,028
& 0.033) and LH:FSH ratio(p=0.038 & 0.495 ) and no statistically significant decrease as regard hirustism in both groups. However, there were no
statistically significant differences between the two groups concerning the
ovulation and pregnancy rates after treatment.
Conclusion:Metformin alone may be an effective drug for restoration of
menstrual irregularities, LH: FSH ratio, treatment of acne, inducing ovulation and increase pregnancy rates in clomiphene citrate resistant polycystic
ovary syndrome. Non obese patients responded better but statistically non
significant than obese patients. Further randomized controlled studies on
large number of patients are required to compare efficacy of metformin in
obese and non obese PCOS patients.