Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome: a randomized controlled trial

Stefano Palomba, Angela Falbo, Lucia Battista, Tiziana Russo, Roberta Venturella, Achille Tolino, Francesco Orio, Fulvio Zullo

Research output: Contribution to journalArticle

Abstract

Objective: The purpose of this study was to compare the effectiveness of laparoscopic ovarian diathermy (LOD) vs clomiphene citrate (CC) plus metformin in infertile patients with CC-resistant polycystic ovary syndrome (PCOS). Study Design: Fifty primary infertile patients with CC-resistant PCOS were assigned randomly to receive LOD followed by a 6-month observation (group A) or 6-cycle course of CC plus metformin (group B). Reproductive and safety outcomes were analyzed. Results: No significant difference between 2 groups in pregnancy (15/92 women [16.3%] vs 14/107 women [13.1%]; P = .521) and live-birth (13/92 women [14.1%] vs 12/107 women [11.2%]; P = .536) rates per cycle was observed. With the use of a Cox regression analysis, patients under medical treatment, compared with patients who received surgical treatment, had a relative risk of pregnancy of 1.2 (95% confidence interval, 0.61-2.44; P = .582) and a relative risk of live-birth of 1.4 (95% confidence interval, 0.63-2.96; P = .425). Conclusion: LOD and CC plus metformin seem to be 2 effective approaches to treat infertility in patients with CC-resistant PCOS.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume202
Issue number6
DOIs
Publication statusPublished - Jun 2010

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Diathermy
Clomiphene
Polycystic Ovary Syndrome
Metformin
Randomized Controlled Trials
Primary Ovarian Insufficiency
Live Birth
Confidence Intervals
Pregnancy
Infertility
Regression Analysis
Observation
Safety
Therapeutics

Keywords

  • clomiphene citrate
  • LOD
  • metformin
  • ovarian
  • ovulation induction
  • PCOS

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome : a randomized controlled trial. / Palomba, Stefano; Falbo, Angela; Battista, Lucia; Russo, Tiziana; Venturella, Roberta; Tolino, Achille; Orio, Francesco; Zullo, Fulvio.

In: American Journal of Obstetrics and Gynecology, Vol. 202, No. 6, 06.2010.

Research output: Contribution to journalArticle

Palomba, Stefano ; Falbo, Angela ; Battista, Lucia ; Russo, Tiziana ; Venturella, Roberta ; Tolino, Achille ; Orio, Francesco ; Zullo, Fulvio. / Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome : a randomized controlled trial. In: American Journal of Obstetrics and Gynecology. 2010 ; Vol. 202, No. 6.
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abstract = "Objective: The purpose of this study was to compare the effectiveness of laparoscopic ovarian diathermy (LOD) vs clomiphene citrate (CC) plus metformin in infertile patients with CC-resistant polycystic ovary syndrome (PCOS). Study Design: Fifty primary infertile patients with CC-resistant PCOS were assigned randomly to receive LOD followed by a 6-month observation (group A) or 6-cycle course of CC plus metformin (group B). Reproductive and safety outcomes were analyzed. Results: No significant difference between 2 groups in pregnancy (15/92 women [16.3{\%}] vs 14/107 women [13.1{\%}]; P = .521) and live-birth (13/92 women [14.1{\%}] vs 12/107 women [11.2{\%}]; P = .536) rates per cycle was observed. With the use of a Cox regression analysis, patients under medical treatment, compared with patients who received surgical treatment, had a relative risk of pregnancy of 1.2 (95{\%} confidence interval, 0.61-2.44; P = .582) and a relative risk of live-birth of 1.4 (95{\%} confidence interval, 0.63-2.96; P = .425). Conclusion: LOD and CC plus metformin seem to be 2 effective approaches to treat infertility in patients with CC-resistant PCOS.",
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