Clomiphene citrate plus metformin Vs. Clomiphene citrate alone for induction of ovulation in women with polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS) represents a combination of hyperandrogenism, chronic anovulation, and polycystic ovaries. It may lead to hirsutism and anovulatory infertility. The present study determined & compared the rate of ovulation, regularisation of the menstrual cycle, and rate of pregnancy by using a combination of Clomiphene citrate + Metformin and Clomiphene citrate alone in patients with PCOS.

The study enrolled 110 patients (55 in each group) with primary subfertility and PCOS diagnosis in the age group of 18 to 40 and looked for the incidence of ovulation (detected by folliculometry). It also assessed the regularisation of menstrual cycle & Pregnancy rates.

The study found-

• Highest overall ovulation at the end of 3rd cycle of ovulation induction, with 48.8% and 41%, respectively, in each group. 
• Significantly higher incidence of ovulation in the group receiving a combination of clomiphene citrate and metformin (83.3%), contrasting to those receiving clomiphene citrate only (65.9%). 
• Significantly higher regularisation of the menstrual cycle & Pregnancy rates in the group given CC plus metformin (89.6%). 
• Higher Pregnancy rates in CC plus metformin group( 33.3%) than 2nd group (20.5%).

This study shows that the combination of clomiphene citrate and metformin is a better choice for the induction of ovulation in women suffering from PCOS than clomiphene citrate alone.

 Chakraborty A. et al. A randomized, double-blind clinical study on effect between clomiphene citrate plus metformin and clomiphene citrate alone on induction of ovulation in women with polycystic ovarian syndrome. Indian J Obstet Gynecol Res 2023;10(2):196-205