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Stefano Palomba, Francesco Orio, Luciano Giovanni Nardo, Angela Falbo, Tiziana Russo, Domenico Corea, Patrizia Doldo, Gaetano Lombardi, Achille Tolino, Annamaria Colao, Fulvio Zullo, Metformin Administration Versus Laparoscopic Ovarian Diathermy in Clomiphene Citrate-Resistant Women with Polycystic Ovary Syndrome: A Prospective Parallel Randomized Double-Blind Placebo-Controlled Trial, The Journal of Clinical Endocrinology & Metabolism, Volume 89, Issue 10, 1 October 2004, Pages 4801–4809, https://doi.org/10.1210/jc.2004-0689
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Abstract
At present, it is unclear what the role is of laparoscopic ovarian diathermy (LOD) and of metformin administration as second-line treatments for ovulation induction in women with polycystic ovary syndrome (PCOS) after failure of clomiphene citrate (CC) treatment. The aim of the present study was to compare in a randomized double-blind placebo-controlled fashion the effectiveness of LOD with metformin administration in the treatment of CC-resistant women with PCOS. A total of 120 overweight primary infertile anovulatory CC-resistant women with PCOS were enrolled and randomized into two groups of treatment. Group A underwent diagnostic laparoscopy, whereas group B underwent LOD. At hospital discharge, the patients were treated for 6 months with metformin cloridrate (group A; 850 mg twice daily) or with multivitamins (group B). The ovulation, pregnancy, abortion, and live-birth rates were evaluated. At the end of the study, the total ovulation rate was not statistically different between both treatment groups (54.8 vs. 55.1% in groups A and B, respectively), whereas the pregnancy (18.6 vs. 13.4%), the abortion (15.4 vs. 29.0%), and the live-birth (82.1 vs. 64.5%) rates were significantly (P < 0.05) different between the two groups. Our data show that metformin administration is more effective than LOD in overall reproductive outcomes in overweight infertile CC-resistant women with PCOS.