Comparing the Effect of Metformin and Acarbose Accompanying Clomiphene on the Successful Ovulation Induction in Infertile Women with Polycystic Ovary Syndrome

Rezai, Masomeh; Jamshidi, Mohmmad; Mohammadbeigi, Robabeh; Seyedoshohadaei, Fariba; Mohammadipour, Somaye; Moradi, Ghobad

doi:10.5539/gjhs.v8n9p281

Cited by 12 publications

(11 citation statements)

References 18 publications

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“…The 80 RCTs were published between 2000 and 2020 and included (4028 participants both PCOS and control) that met the inclusion criteria and were included in the meta‐analysis. Forty‐two trials 20–61 diagnosed PCOS based on the Rotterdam 2003 criteria, 62 10 trials 35,63–72 used the National Institute of Health 1990 (NIH, NICHD) criteria, one trial 73 used the Androgen Excess Society 2006 (AES) criteria, 74 and no diagnostic criteria were specified for the remainder of the trials (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Abdalla

Shah

Deshmukh

et al. 2022

Clinical Endocrinology

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Context Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age and is associated with increased body weight. Objective To review the literature on the effect of different pharmacological interventions on the anthropometric indices in women with PCOS. Data sources We searched PubMed, MEDLINE, Scopus, Embase, Cochrane library, and the Web of Science in April 2020 with an update in PubMed in March 2021. Study selection The study followed the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA)2020. Data extraction Reviewers extracted data and assessed the risk of bias using the Cochrane risk of bias tool. Results 80 RCTs were included in the meta‐analysis. Metformin vs placebo showed significant reduction in the mean body weight (MD: −3.13 kg; 95% confidence interval [CI]: −5.33 to −0.93, I² = 5%) and the mean body mass index (BMI) (MD: −0.75 kg/m2; 95% CI: −1.15 to −0.36, I² = 0%). There was a significant reduction in the mean BMI with orlistat versus placebo (MD: −1.33 kg/m²; 95% CI: −2.16 to −0.66, I² = 0.0%), acarbose versus metformin (MD: −1.26 kg/m²; 95% CI: −2.13 to −0.38, I² = 0%), and metformin versus pioglitazone (MD: −0.91 kg/m²; 95% CI: −1.62 to −0.19, I² = 0%). A significant increase in the mean BMI was also observed in pioglitazone versus placebo (MD: + 2.59 kg/m²; 95% CI: 1.78–3.38, I² = 0%) and in rosiglitazone versus metformin (MD: + 0.80 kg/m²; 95% CI: 0.32–1.27, I² = 3%). There was a significant reduction in the mean waist circumference (WC) with metformin versus placebo (MD: −1.21 cm; 95% CI: −3.71 to 1.29, I² = 0%) while a significant increase in the mean WC with pioglitazone versus placebo (MD: + 5.45 cm; 95% CI: 2.18–8.71, I² = 0%). Conclusion Pharmacological interventions including metformin, sitagliptin, pioglitazone, rosiglitazone orlistat, and acarbose have significant effects on the anthropometric indices in women with PCOS.

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Section: Resultsmentioning

confidence: 99%

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Abdalla

Shah

Deshmukh

et al. 2022

Clinical Endocrinology

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“…Previous studies have shown that acarbose combined with clomiphene is more effective than metformin in inducing ovulation and reducing body mass index in infertile women with polycystic ovary syndrome. 19 Before treatment, no obvious differences were found in sex hormone levels, glycolipid metabolism or inflammatory factor levels between the two groups (P > 0.05). After treatment, all ex-hormone levels, glycolipid metabolism and inflammatory factor levels were improved in both groups, which were more significant in the observation group compared with the control group (P < 0.05).…”

Section: A H E a D O F P R I N Tmentioning

confidence: 84%

Effect of acarbose combined with diet intervention on glycolipid metabolism in patients with primary polycystic ovarian syndrome complicated with impaired glucose tolerance

Yang¹,

Zhang²,

Zhang³

et al. 2022

Pak J Med Sci

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Objectives: To investigate the efficacy of acarbose combined with diet intervention in patients with primary polycystic ovarian syndrome (PCOS) complicated with impaired glucose tolerance (IGT) and its effect on their glycolipid metabolism. Methods: A total of 92 patients with primary PCOS complicated with IGT treated in our hospital from December 2018 to December 2020 were selected, and divided into two groups using a random number table. The control group received routine lifestyle intervention. On this basis, the observation group was treated with acarbose combined with diet intervention. The menstrual recovery rate, ovulation rate and pregnancy rate after treatment, as well as sex hormone levels, glycolipid metabolism and inflammatory factor levels before and after treatment were compared between the two groups. Results: After treatment, the menstrual recovery rate and ovulation rate of the observation group were significantly higher than those of the control group (P < 0.05). Among the patients with fertility needs in the two groups, the pregnancy rate of the observation group was significantly higher compared with the control group (P < 0.05). Before treatment, sex hormone levels showed no obvious differences between the two groups (P > 0.05). After treatment, all indicators of sex hormone were improved in both groups, and the improvement in the observation group was more obvious than that in the control group (P < 0.05). Before treatment, no obvious difference was found in glycolipid metabolism between the two groups (P > 0.05). After treatment, 2hPG, LDL-C and TG were improved in both groups, and the improvement was more significant in the observation group compared with the control group (P < 0.05). Before treatment, inflammatory factor levels were not significantly different between the two groups (P > 0.05). After treatment, inflammatory factor levels in both groups were improved, which was more obvious in the observation group than the control group (P < 0.05). Conclusions: The application of acarbose combined with diet intervention in patients with primary PCOS complicated with IGT can effectively enhance the efficacy, help patients increase ovulation rate and pregnancy rate, and improve sex hormone levels, glycolipid metabolism and inflammatory factor levels. doi: https://doi.org/10.12669/pjms.38.4.4598 How to cite this:Riaz A, Sughra U, Jawaid SA, Masood J. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4598 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…The 58 RCTs were published until 2020, of which 35 RCTs (60.3%) 23,25–27,30–35,40,41,44–46,48,49,51–53,57,58,61,67–70,72,74,76,79–81 diagnosed PCOS based on the Rotterdam criteria 2003 85 ; nine (15.5%) RCTs 24,39,43,47,50,55,56,71,73 used the National Institute of Health 1990 (NIH, NICHD) criteria 86 while no diagnostic criteria were given for the rest of the RCTs (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Two (3.4%) RCTs compared orlistat with placebo 31,58 . Three (5.2%) RCTs examined acarbose with metformin 39,67,71 . Two (3.4%) RCTs compared saxagliptin with metformin 33,74 .…”

Section: Resultsmentioning

confidence: 99%

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Impact of pharmacological interventions on insulin resistance in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Abdalla

Shah

Deshmukh

et al. 2021

Clinical Endocrinology

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Objective Polycystic ovary syndrome (PCOS) is a complex endocrine condition affecting women of reproductive age. It is characterized by insulin resistance and is a major risk factor for type 2 diabetes mellitus (T2DM). The objective was to review the literature on the effect of different pharmacological interventions on insulin resistance in women with PCOS. Design We searched PubMed, MEDLINE, Scopus, Embase, Cochrane library and the Web of Science in April 2020 and updated in March 2021. The study follows the 2020 Preferred Reporting Items for Systematic reviews and Meta‐ana. Reviwers extracted data and assessed the risk of bias using the Cochrane risk of bias tool. Results In 58 randomized controlled trials there were significant reductions in the fasting blood glucose (FBG) with metformin versus placebo (standardized mean difference [SMD]: −0.23; 95% confidence interval [CI]: −0.40, −0.06; I² = 0%, low‐grade evidence), and acarbose versus metformin (mean difference [MD]: −10.50 mg/dl; 95% CI: −15.76, −5.24; I² = 0%, low‐grade evidence). Significant reductions in fasting insulin (FI) with pioglitazone versus placebo (SMD: −0.55; 95% CI: −1.03, −0.07; I² = 37%; p = .02, very‐low‐grade evidence). A significant reduction in homoeostatic model assessment of insulin resistance (HOMA‐IR) was seen with exenatide versus metformin (MD: −0.34; 95% CI: −0.65, −0.03; I² = 0%, low‐grade evidence). No effect on homoeostatic model assessment of beta cells (HOMA‐B) was observed. Conclusions Pharmacological interventions, including metformin, acarbose, pioglitazone and exenatide have significant effects on FBG, FI, HOMA‐IR but not on HOMA‐B.

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Comparing the Effect of Metformin and Acarbose Accompanying Clomiphene on the Successful Ovulation Induction in Infertile Women with Polycystic Ovary Syndrome

Cited by 12 publications

References 18 publications

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Effect of acarbose combined with diet intervention on glycolipid metabolism in patients with primary polycystic ovarian syndrome complicated with impaired glucose tolerance

Impact of pharmacological interventions on insulin resistance in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

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