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Standard Therapy More Effective in Common Fertility Disorder

igned 626 infertile women with PCOS to one of three groups, explained the study’s lead investigator, Richard. S. Legro, M.D., of the Department of Obstetrics and Gynecology at Penn State College of Medicine in Hershey, Pennsylvania. The first group received clomiphene and a placebo, the second group received metformin and a placebo, and the third group received both metformin and clomiphene. The women took the treatments for up to six months. The researchers tested the women’s levels of the hormone progesterone to gauge when the women were ovulating.

The researchers found that fewer women in the metformin only group had given birth than had women in either of the clomiphene groups. In the metformin only group, 15 out of 208 women had given birth, or 7.2 percent. In the clomiphene only group, 47 out of 209 women had given birth, or 22.5 percent. In the combined clomiphene-metformin group, 56 out of 209 women had given birth (26.8 percent). The difference in the number of births between the clomiphene only group and the combined clomiphene-metformin group was not statistically significant. The researchers also found that, compared to the other women in the study, obese women were less likely to conceive during the course of the study and less likely to ovulate in response to metformin.

The researchers noted that women in the combination therapy group ovulated more frequently than did the women in either the clomiphene-alone or the metformin-alone groups. However, the tendency to ovulate more frequently did not translate into a significantly greater number of pregnancies for the combination group.

Dr. Legro said that these findings were consistent with earlier studies that also reported an increase in ovulation from the combined therapy and that these early observations had led to researchers’ initial enthusiasm for metformin as a potential treatment for PCOS. He theorized that although the combination of the two drugs might stimula
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