Comparative Study of Metformin Versus Clomiphine Citrate for Ovulation Induction in Polycystic Ovary Syndrome at Lady Willingdon Hospital Lahore

Background: Metformin has given quite encouraging results in a number of patients improving overall ovarian health and inducing pregnancies. Objective: The Purpose of this study was to compare the effectiveness of combined treatment regimen Metformin and Clomiphene citrate with Clomiphene citrate alone for ovulation induction. Methodology: This randomized controlled trial was conducted over a period of 2 years from Jan. 2008 to Jan 2010. This study includes prospective analysis of PCOS subjects, who were treated in Gynaecological unit II of Lady Willingdon Hospital Lahore. Two hundred subjects were recruited and then divided randomly into two groups, A and B. Group A, included one hundred patients (50%) who were treated with clomiphine citrate only while Group B, included one hundred patients who were treated with Metformin and clomiphine citrate both. The collected data was entered into SPSS version 17 and were analysed accordingly applying descriptive statistics e.g. mean, frequency and analytical e.g. t-test and Chi Square. Results: Mean age at presentation of group-A was 26.52  0.23 which when compared with that of group – B 26.17  0.25 did not differ statistically (PValue = 0.306 – in significant). Similarly age at menarche of group A (CC) 12.82  0.08 did not show statistical difference when compared with that of group – B (CC + met) 13.04  0.11 (P-Value = 0.123 – insignificant) or 0.05. As for as duration of infertility was concerned it was 5.28  0.27 yrs for group – A and 4.99  0.20 years, for group – B. Overall, 125 (62.5%) women ovulated, out of which 46 (36.8%) were from Group – A while 79 (63.2) were from Group – B). Conclusion: Metformin may be a therapeutic option for PCOS based on improvement in laboratory and clinical parameters. Our results also establish guidelines for metformin treatment with special implication on non-obese patients. It should be recommended for being effective as well as ecnomical.