Does Metformin combined with Clomiphene Citrate improve fertility related outcomes in Clomiphene resistant women with PCOS: A systematic review

Publication date: June 2014 Source:Middle East Fertility Society Journal, Volume 19, Issue 2 Author(s): Sabraj Gill , Ailsa Gemmell , Rebecca Colleran , Nurhazwani Bt Zanuri , Helen O’Brien , Amudha Poobalan Background Polycystic Ovary Syndrome (PCOS) is clinically associated with infertility. Many women are resistant to Clomiphene Citrate and the addition of insulin sensitisers may help to overcome this challenge. Objective This review aims to assess if Metformin added to Clomiphene Citrate improves pregnancy outcomes in patients with PCOS and are resistant to Clomiphene Citrate. Search strategy A systematic search was conducted on four electronic databases published until May 2013. Selection criteria Studies evaluating the use of Metformin in combination with Clomiphene Citrate resistant patients with PCOS compared to placebo. Outcomes assessed were ovulation rate, pregnancy by ultrasound, Sex Hormone Binding Globulin (SHBG), BMI, fasting insulin and testosterone levels. Data collection and analysis The reviewers carried out data extraction of specific outcomes and evaluated each study according to the sign guidelines. Main results In total 40 citations were identified however only four were eligible for analysis. Two studies were found to have a statistically significant improvement in ovulation and pregnancy rates in the intervention group compared to the control group. These studies used the highest dose of Metformin and Clomiphene Citrate. In two s...
Source: Middle East Fertility Society Journal - Category: Reproduction Medicine Source Type: research