Comparison of metformin treatment and laparoscopic ovarian diathermy in patients with polycystic ovary syndrome
Received 4 May 2009; received in revised form 7 June 2009; accepted 13 June 2009. published online 04 September 2009.
Abstract
Objective
To compare hormone levels and clinical outcomes in patients with polycystic ovary syndrome (PCOS) after metformin therapy or laparoscopic ovarian diathermy (LOD) at 6 months follow-up.
Methods
A randomized trial was conducted in 126 patients with PCOS who had a history of infertility for at least 1 year and resistance to clomiphene citrate (CC). Patients (n=63) received metformin treatment or underwent LOD (n=63).
Results
Levels of follicle-stimulating hormone did not change in either group after the intervention (P>0.05). Serum levels of testosterone (P<0.001) and luteinizing hormone (P<0.001) were significantly lower after the treatment in both groups. The proportion of women with regular menstrual cycles increased significantly to 35% (P<0.001) in the LOD group and to 49% (P<0.001) in metformin group compared with before the intervention. Although proportion was higher in the metformin group compared with the LOD group, the difference was not significant (odds ratio 1.81; 95% CI, 0.88–3.69, P=0.1). Hirsutism decreased significantly from 100% to 79.37% (P<0.001) in both groups.
Conclusion
CC-resistant patients with PCOS were treated effectively by both metformin and LOD.
aDepartment of Gynecology and Obstetrics, Roointan-Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
bDepartment of Endocrinology and Female Infertility, Royan Institute, ACECR, Tehran, Iran
Corresponding author. Department of Gynecology and Obstetrics, Roointan-Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98 21 77883283; fax: +98 21 77883196.
ABSTRACT