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Efficacy of combined metformin-letrozole in comparison with bilateral ovarian drilling in clomiphene-resistant infertile women with polycystic ovarian syndrome
Faculty
Medicine
Year:
2013
Type of Publication:
Article
Pages:
119-123
Authors:
Abd Elgafor, Ibrahim
DOI:
10.1007/s00404-013-2714-2
Journal:
ARCHIVES OF GYNECOLOGY AND OBSTETRICS SPRINGER HEIDELBERG
Volume:
288
Research Area:
Obstetrics \& Gynecology
ISSN
ISI:000320383500018
Keywords :
Metformin, Letrozole, Ovarian drilling, Clomiphene resistant, Polycystic ovary
Abstract:
To compare the hormonal-metabolic profiles and reproductive outcomes between women receiving metformin plus letrozole and women undergoing bilateral ovarian drilling in clomiphene citrate (CC)-resistant women with polycystic ovary syndrome (PCOS). In this randomized study, 146 patients were randomly allocated into group 1 (n = 73) who received metformin plus letrozole, and group 2 (n = 73) who underwent bilateral ovarian drilling. Comparison was done between the basal and after treatment biochemical values for each group, in addition reproductive outcomes after treatment were compared between both groups. There was significant reduction in testosterone (p a parts per thousand currency sign 0.001), fasting insulin (p a parts per thousand currency sign 0.001), and fasting glucose/fasting insulin ratio (p = 0.029) in metformin plus letrozole group, while there was significant reduction in FSH, LH and LH/FSH ratio in bilateral drilling group (p a parts per thousand currency sign 0.001, 0.001 and 0.001). No significant difference in cycle regularity (p = 0.82), ovulation (p = 0.24), pregnancy rate (p = 0.32) and abortion rate (p = 0.51) between both groups. Both metformin plus letrozole and bilateral ovarian drilling are similarly effective as second-line strategies for the treatment of women with PCOS who do not conceive with CC.
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