Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome

Stefano Palomba, Angela Falbo, Francesco Orio, Achille Tolino, Fulvio Zullo

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors. Design: Prospective controlled study. Setting: Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy. Patient(s): Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age. Intervention(s): Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day). Main Outcome Measure(s): Baseline clinical and biochemical parameters categorized according to interventions response. Result(s): The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC. Conclusion(s): Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI.

Original languageEnglish
Pages (from-to)2557-2567
Number of pages11
JournalFertility and Sterility
Volume91
Issue number6
DOIs
Publication statusPublished - Jun 2009

Fingerprint

Clomiphene
Polycystic Ovary Syndrome
Metformin
Body Mass Index
Androgens
Therapeutics
Primary Ovarian Insufficiency
Ovulation
Pregnancy
Insulin Resistance
Insulin
Hospital Obstetrics and Gynecology Department
Gynecology
Infertility
Italy
Research Design
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • Clomiphene citrate
  • metformin
  • ovulation
  • PCOS
  • predictors
  • pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome. / Palomba, Stefano; Falbo, Angela; Orio, Francesco; Tolino, Achille; Zullo, Fulvio.

In: Fertility and Sterility, Vol. 91, No. 6, 06.2009, p. 2557-2567.

Research output: Contribution to journalArticle

Palomba, Stefano ; Falbo, Angela ; Orio, Francesco ; Tolino, Achille ; Zullo, Fulvio. / Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome. In: Fertility and Sterility. 2009 ; Vol. 91, No. 6. pp. 2557-2567.
@article{f9f36d090f644f18873b0588bbacf752,
title = "Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome",
abstract = "Objective: To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors. Design: Prospective controlled study. Setting: Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy. Patient(s): Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age. Intervention(s): Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day). Main Outcome Measure(s): Baseline clinical and biochemical parameters categorized according to interventions response. Result(s): The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC. Conclusion(s): Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI.",
keywords = "Clomiphene citrate, metformin, ovulation, PCOS, predictors, pregnancy",
author = "Stefano Palomba and Angela Falbo and Francesco Orio and Achille Tolino and Fulvio Zullo",
year = "2009",
month = "6",
doi = "10.1016/j.fertnstert.2008.03.011",
language = "English",
volume = "91",
pages = "2557--2567",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Efficacy predictors for metformin and clomiphene citrate treatment in anovulatory infertile patients with polycystic ovary syndrome

AU - Palomba, Stefano

AU - Falbo, Angela

AU - Orio, Francesco

AU - Tolino, Achille

AU - Zullo, Fulvio

PY - 2009/6

Y1 - 2009/6

N2 - Objective: To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors. Design: Prospective controlled study. Setting: Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy. Patient(s): Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age. Intervention(s): Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day). Main Outcome Measure(s): Baseline clinical and biochemical parameters categorized according to interventions response. Result(s): The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC. Conclusion(s): Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI.

AB - Objective: To evaluate ovulation and pregnancy predictors in infertile polycystic ovary syndrome (PCOS) patients who received clomiphene citrate (CC) and metformin as first-line ovulation inductors. Design: Prospective controlled study. Setting: Departments of Obstetrics and Gynecology, Universities Magna Graecia of Catanzaro and Federico II of Naples, Italy. Patient(s): Eighty infertile anovulatory PCOS patients allocated in two groups matched for body mass index (BMI) and age. Intervention(s): Metformin (1700 mg/day for 6 months) or CC (50 mg/day, increasing doses up to 250 mg/day). Main Outcome Measure(s): Baseline clinical and biochemical parameters categorized according to interventions response. Result(s): The BMI was statistically significantly lower in patients who ovulated under both treatments. Insulin sensitivity indexes were statistically significantly worse in patients who ovulated under metformin and statistically significantly better in patients who ovulated under CC. Androgen levels and free androgen index (FAI) were statistically significantly lower in ovulatory patients than in anovulatory ones who received CC. Age, BMI, infertility duration, and insulin sensitivity indexes were statistically significantly different between patients who achieved and those who did not achieve a pregnancy under both treatments. Androgens levels and FAI were statistically significantly lower in patients who achieved a pregnancy under CC. Conclusion(s): Insulin-resistant PCOS patients with low BMI are more likely to respond to metformin whereas CC treatment is more effective in less hyperandrogenic and insulin-resistant PCOS patients with low BMI.

KW - Clomiphene citrate

KW - metformin

KW - ovulation

KW - PCOS

KW - predictors

KW - pregnancy

UR - http://www.scopus.com/inward/record.url?scp=67349244072&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67349244072&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2008.03.011

DO - 10.1016/j.fertnstert.2008.03.011

M3 - Article

C2 - 18440534

AN - SCOPUS:67349244072

VL - 91

SP - 2557

EP - 2567

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 6

ER -