Leanza V, Coco L, Grasso F, Leanza G, Zarbo G, Palumbo M
Obstetric and Gynecology, Department Of Surgery, Catania University, Italy -
Minerva Ginecol. 2014 Jun;66(3):299-301.
Polycystic ovary syndrome (PCOS) is one of the most common causes of ovulatory infertility. It is an endocrine disorders characterized by a high level of male hormones (androgens) and frequent anovulatory cycles associated with multiple ovarian microcysts. The aim of this paper was to evaluate effects of a Clomiphene citrate alone versus a combined treatment (Metformin and Clomiphene citrate).
A total of 60 women with PCOS and infertility were evaluated. Inclusions criteria were: age 26-34 years, nulliparity, above 3 years of sterility, multiple ovarian microcysts, BMI>27.5, oligomenorrhea/amenorrhea, hyperandrogenism and normal male fertility. Four patients were excluded (renal damage 2, tubal occlusion 1 and Pelvic Inflammatory Disease 1). The remaining 56 were divided into 2 groups: group A were inducted with Clomiphene Citrate alone, while group B were inducted with Clomiphene citrate and Metformin.
In group A we obtained ovulation in 20 women (71.4%), 8 pregnancies (28.5%) and one (3.5%) spontaneous abortion. In group B we obtained ovulation in 24 women (85.7%), 15 pregnancies (53.5%) and no spontaneous abortions.
Combined treatment was found to be more effective (53.5) in improving pregnancy rate compared to monotherapy (28.5%).
多囊卵巢综合征（PCOS）是排卵性不孕症最常见的病因之一。它是一种内分泌紊乱疾病，其特征为雄激素水平高以及与多个卵巢微囊肿相关的频繁无排卵周期。本文的目的是评估单独使用枸橼酸氯米芬与联合治疗（二甲双胍和枸橼酸氯米芬）的效果。
共评估了60例患有PCOS和不孕症的女性。纳入标准为：年龄26 - 34岁，未生育，不孕3年以上，多个卵巢微囊肿，BMI>27.5，月经过少/闭经，高雄激素血症以及男性生育能力正常。排除4例患者（2例肾损伤，1例输卵管阻塞和1例盆腔炎）。其余56例分为2组：A组单独使用枸橼酸氯米芬诱导排卵，而B组使用枸橼酸氯米芬和二甲双胍诱导排卵。
A组20名女性（71.4%）排卵，8例怀孕（28.5%），1例（3.5%）自然流产。B组24名女性（85.7%）排卵，15例怀孕（53.5%），无自然流产。
与单一疗法（28.5%）相比，联合治疗在提高妊娠率方面更有效（53.5%）。
