Combined metformin and clomiphene citrate versus laparoscopic ovarian diathermy for ovulation induction in clomiphene‐resistant women with polycystic ovary syndrome: A randomized controlled trial

Hashim, Hatem Abu; Lakany, Naser El; Sherief, Lotfy S.

doi:10.1111/j.1447-0756.2010.01383.x

Cited by 27 publications

(30 citation statements)

References 41 publications

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“…15 Miscarriage rate following LOD in our series was similar to the previously reported figures. 25,26 Of the five multiple pregnancies reported in our cohort none occurred after spontaneous conception and their frequency was similar to what was previously described (0% -10%). 15 Laparoscopic ovarian diathermy is not a curative treatment for PCOS, but is associated with long-term beneficial effects.…”

Section: Discussionsupporting

confidence: 89%

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Luz¹,

Barros²,

Aguiar³

et al. 2016

Acta Med Port

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Introduction:Polycystic ovary syndrome is the most frequent cause of anovulatory infertility and management involves a multistep approach. Laparoscopic ovarian diathermy is accepted as a second-line treatment of patients who failed to respond to clomiphene citrate. The aims of this study were to determine the efficacy of this technique at short and long-term and to perform an analysis of predictive factors of spontaneous pregnancy. Material and Methods:This retrospective study involved 76 women who underwent laparoscopic ovarian diathermy between 2004 and 2013 in a university hospital. Main outcomes were cycle regularity and pregnancy. Short-term outcomes recorded during followup in our centre were reviewed and long-term outcomes were evaluated by a telephone interview to all women whose surgery was undertaken more than three years ago. Clinical and biochemical data were analysed as predictive factors of spontaneous conception in patients without other infertility factors.Results: Menstrual cycle regularity was initially achieved in 53 (70%) women and in the long-term follow-up subgroup, 52% (12/23) had regular periods. In general, 53 (70%) women conceived and 77 pregnancies were achieved, 60% of which were spontaneous. The only prognostic factor found to be significantly associated with spontaneous conception was a shorter duration of infertility (< 3 years) (p < 0.05). Discussion: Laparoscopic ovarian diathermy showed pregnancy rates comparable to other ovulation induction treatments with the advantage of having a long lasting beneficial effect in menstrual regularity and fertility. Conclusion: Laparoscopic ovarian diathermy is a safe and effective treatment option for anovulatory infertility in women with polycystic ovary syndrome.

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Section: Discussionsupporting

confidence: 89%

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Luz¹,

Barros²,

Aguiar³

et al. 2016

Acta Med Port

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“…Of 132 articles screened, 16 studies were identified as potentially eligible for inclusion. Only 12 RCTs fulfilled the inclusion criteria . Four trials were excluded for the following reasons: one study was a prospective study but not an RCT ; another study was a prospective quasi‐randomized trial ; sensitivity to clomiphene was not reported in one RCT ; one RCT compared metformin with LOD for six cycles with addition of clomiphene after the end of the study if no pregnancy was achieved .…”

Section: Resultsmentioning

confidence: 99%

“…Across the 12 RCTs, five different comparisons of metformin+clomiphene were made with each of the following treatment options: LOD (two RCTs, n = 332) ; gonadotrophins (three RCTs, n = 323) ; aromatase inhibitors (three RCTs, n = 409) ; NAC+clomiphene (one RCT, n = 192) and other insulin sensitizers+clomiphene (three RCTs, n = 155) . The baseline of all trials was comparable (Table S2).…”

Section: Resultsmentioning

confidence: 99%

Combined metformin‐clomiphene in clomiphene‐resistant polycystic ovary syndrome: a systematic review and meta‐analysis of randomized controlled trials

Hashim

Foda

Ghayaty

2015

Acta Obstet Gynecol Scand

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“…Nonetheless, in randomised clinical trials [10], it was also settled that the MET combined with CC is an effective treatment, both in ovulation induction and in reaching gestation in women affected by PCOS.…”

Section: Introductionmentioning

confidence: 99%

Metformin Usage to Induce Ovulation in Women With Polycystic Ovary Syndrome: Meta-Analysis

Steimbach

Loução

Carraro

et al. 2016

Int J Pharm Pharm Sci

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Objective: To evaluate the use of MET in ovulation induction and pregnancy rates in a woman with polycystic ovary syndrome (PCOS). Methods:A meta-analysis of randomised clinical trials (RCT) that presented ovulation and gestation rates in women with PCOS, after administering CC or M et al. one or combined was performed. The studies were selected according to the inclusion criteria in PCOS patients, resistant to CC or not. Results:The meta-analysis demonstrated that MET and CC did not significantly increase the ovulation (Odds Ratio 1.72 [0.71, 4.12]) and gestation (OR 1.33 [0.88, 2.02]) rates when compared to the usage of CC itself in women not resistant to CC. However, in women with CC-resistant PCOS, the group treated with CC and MET presented higher rates of ovulation (Odds Ratio = 14.57 [4.96, 42.81]) and gestation (Odds Ratio = 11.86 [2.45, 57.36]) than patients treated only with CC. Conclusion:The combination of MET and CC did not show advantages over the administration of CC alone in women not resistant to CC. However, MET may show satisfactory results in women resistant to CC.

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Combined metformin and clomiphene citrate versus laparoscopic ovarian diathermy for ovulation induction in clomiphene‐resistant women with polycystic ovary syndrome: A randomized controlled trial

Abstract: Combined metformin-CC and LOD are equally effective for inducing ovulation and achieving pregnancy in CC-resistant PCOS patients.

Cited by 27 publications

References 41 publications

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Combined metformin‐clomiphene in clomiphene‐resistant polycystic ovary syndrome: a systematic review and meta‐analysis of randomized controlled trials

Metformin Usage to Induce Ovulation in Women With Polycystic Ovary Syndrome: Meta-Analysis

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