Department of Obstetrics and Gynecology, Haseki Education and Research Hospital, Istanbul, Turkey.
Arch Gynecol Obstet. 2010 Oct;282(4):439-43. doi: 10.1007/s00404-010-1497-y. Epub 2010 May 16.
To compare the efficacy of metformin and clomiphene citrate (CC) therapies for ovulation induction in anovulatory infertile women with polycystic ovary syndrome (PCOS).
A total of 69 consecutive infertile, anovulatory women with PCOS were enrolled in this prospective, non-randomized trial. The women were prescribed either 1,700 mg/day metformin or CC with a starting dose of 50 mg/day up to 150 mg/day for a period of six consecutive cycles.
Metformin and CC groups were followed for a total of 136 and 94 cycles, respectively. Metformin group had lower rates of ovulation when compared with CC group (32.3 vs. 60.6%, respectively; p = 0.004). There was no statistical difference in pregnancy rates per cycle between the treatment groups (8 vs. 11.7%, respectively; p = 0.33) leading to similar cumulative pregnancy rates (36.6 vs. 35.4%, respectively; p = 0.45). No difference was observed among the abortion rates (10 vs. 10%, respectively; p > 0.05) between the groups.
Although metformin and CC are two effective first-line approaches for improving pregnancy rates in anovulatory PCOS women, CC is associated with higher rates of ovulation.
比较二甲双胍和枸橼酸氯米酚（CC）治疗多囊卵巢综合征（PCOS）无排卵性不孕患者排卵的疗效。
本前瞻性、非随机试验纳入了 69 例连续的、无排卵的 PCOS 不孕女性。这些女性被处方 1700mg/天的二甲双胍或起始剂量为 50mg/天的 CC，最多用到 150mg/天，连续治疗 6 个周期。
二甲双胍组和 CC 组分别随访了 136 个和 94 个周期。与 CC 组相比，二甲双胍组的排卵率较低（分别为 32.3%和 60.6%；p=0.004）。两组的每个周期妊娠率没有统计学差异（分别为 8%和 11.7%；p=0.33），导致相似的累积妊娠率（分别为 36.6%和 35.4%；p=0.45）。两组的流产率（分别为 10%和 10%；p>0.05）也没有差异。
尽管二甲双胍和 CC 是改善无排卵性 PCOS 女性妊娠率的两种有效一线方法，但 CC 与更高的排卵率相关。
