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Metformin Increases Ovulation in Women with Polycystic Ovary Syndrome Better than Clomiphene Citrate: Presented at ASRM

By Amanda Strong

MONTREAL, QC -- October 21, 2005 -- Metformin is more effective than clomiphene citrate (CC) for ovulation induction in women with polycystic ovary syndrome (PCOS) and achieves equivalent pregnancy rates, according to a poster presented here on October 18^th at the annual meeting of the American Society of Reproductive Medicine (ASRM).

"Both metformin and CC are being used for ovulation induction, but they have never been compared head to head," said lead author Nathalie Neveu, MD, Clinical Research Fellow, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.

The study involved 154 women who were referred to a fertility clinic for treatment of PCOS and infertility. The women were stratified according to whether they had initially been prescribed 50 mg of CC between days 5 and 9 of the cycle, 500 mg of metformin 3 times daily, or a combination of the two, for induction of ovulation.

Although metformin was more likely to have been prescribed for women with a higher body mass index (BMI), women given metformin alone had an increased ovulation rate compared with those given CC alone (75.4% versus 50%, respectively; P = .005).

No benefit for ovulation induction was observed in women given the combination of the two drugs, compared with women receiving metformin alone.

When the researchers excluded women with morbid obesity (BMI>40) from the analysis, the difference in BMI among the three treatment groups was no longer significant (P = .111). However, the ovulation rate was still significantly higher in the metformin group compared to the CC group (P = .029). Pregnancy rates were equivalent across all three groups (35.7%, 45.6% and 31.7% for Groups 1, 2, and 3, respectively; P = .0.332).

The results of the study suggest that metformin should be offered first-line for ovulation induction in all women with PCOS, the authors concluded.

"Metformin, considering all its beneficial effects on the metabolism, is a better option than clomipherate citrate, which also has negative effects on the endometrium," Dr. Neveu said.


[Presentation title: Comparison of Clomiphene Citrate (CC), Metformin or the Combination for First Line Ovulation Induction and Achievement of Pregnancy in 154 Women with Polycystic Ovary Syndrome (PCOS). Poster P-750]

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