Effect of Metformin Versus Diet and Exercise on Ovulation & Menstrual Regularity in PCOS

To compare the effects of metformin with diet & exercise on ovulation & menstrual regularity in PCOS infertile women .Study Design: Randomized clinical trial.Place & Duration of study: Private hospital infertility clinic at Karachi from 2001-2004.Patients & Methods: One hundred & eleven PCOS women with primary infertility were enrolled. and divided into group A & B with 57 & 54 patientsrespectively. Group A received tablet metformin 500mg thrice daily along with diet & exercise advice while group B was kept on diet & exercise alone(30-60 minutes walk daily & avoidance of oily foods, red meat & bakery products) for a period of 90 days. Menstrual regularity & plasma progesteronelevel were evaluated at day-0 and day-90. Fasting serum glucose, insulin, follicle stimulating hormone, luteinizing hormone, prolactin, testosterone &ultrasound pelvis were done at day- 0 for diagnosis of PCOS.Results: 100 patients completed the study. 50 patients in each group.In group A, 44 (88%) patients developed regular cycles with statistically significantincrease in serum progesterone whereas in group B only 3(6%) patients developed regular cycles with non-significant increase in serum progesterone levelfrom day-0 to day-90. Group A showed ovulation in 82% patients in comparison to Group B where ovulation occurred in only 6% of patients.Conclusion: Metformin produced beneficial effects in comparison to diet & exercise alone in PCOS infertile women