Prospective Parallel Randomized, Double-Blind, Double-Dummy Controlled Clinical Trial Comparing Clomiphene Citrate and Metformin as the First-Line Treatment for Ovulation Induction in Nonobese Anovulatory Women with Polycystic Ovary Syndrome

Abstract

Six-month metformin administration is significantly more effective than six-cycle CC treatment in improving fertility in anovulatory nonobese PCOS women.

Effect of Metformin and Clomiphene Citrate in Improving Fertility in Subfertile Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial

“…In the present study, a significant difference was found in cumulative pregnancy rate between metformin and clomiphene group 60% versus 33.3%; P = 0.02 which goes in accordance with Palomba 19 . Their study showed that, over six months of treatment a significant difference was observed in the cumulative pregnancy rate (68.9% vs 34% in metformin and CC group respectively; (P<0.001).…”

What is the best first-step therapeutic approach in treating anovulatory infertility in patients with polycystic ovary syndrome? Questions that are still unanswered

“…These data disagree with an our previous head-to-head RCT [11] comparing metformin with CC, which demonstrated that, in an infertile non-obese PCOS population, metformin is equally as effective as CC for inducing ovulation but is superior in terms of pregnancy rate.…”

“…The administration of metformin induces ovulatory cycles in anovulatory CC-resistant or non-resistant patients with PCOS and improves the ovulation rate as an additional treatment in women who received CC [10,11].…”

The effects of metformin or orlistat on obese women with polycystic ovary syndrome: a prospective randomized open-label study

“…Short term use of metformin resulted in 25% ovulation [25]. In another short term study, 12 week use of metformin led to 73% ovulation [26].But 6 month use of metformin resulted in 62.9% [27], 55.4% ovulation [28].…”