Sequential treatment of metformin and clomiphene citrate in clomiphene-resistant women with polycystic ovary syndrome: a randomized, controlled trial

Abstract

Sequential treatment with metformin and clomiphene citrate is an effective and safe option for clomiphene-resistant women with PCOS.

Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials

“…In no RCT was metformin was administered during pregnancy; its administration was always continued until achieving positive pregnancy test (22,32,34,41,42,46,51,52,55,56) or stopped at human chorionic gonadotropin (hCG) injection (36,38,40,43,45,48). However, one study provided no data in this effect regard (39).…”

Ovulation induction with clomiphene or gonadotropins

“…Of those on metformin, 19 of 21 ovulated compared with 2 of 25 on placebo [14]. In an interesting RCT, CC-resistant women with PCOS received either metformin for 6 months and then CC, or hMG alone for ovulation induction [15]. In this small study, as metformin + CC was equally as effective as hMG, less expensive and more convenient, it was suggested as an intermediary step for CC resistant patients, worth trying before resorting to hMG.…”

Symposium

“…Gonadotrophin treatment was compared with an insulin sensitizing agent in one small trial (George et al, 2003). The trial involved six cycles of hMG or six months metformin treatment followed by 3 cycles of clomifene citrate with metformin.…”