Comparison of metformin treatment and laparoscopic ovarian diathermy in patients with polycystic ovary syndrome

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.

Keywords: Follicle-stimulating hormone, Laparoscopic ovarian diathermy, Luteinizing hormone, Metformin, Polycystic ovary syndrome, Testosterone