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Background: Insulin resistance is common in women with Polycystic
Ovary Syndrome
(PCOS) and can cause poor outcome of infertility
treatment. The aim of our study
was to assess the effect of treatment with metformin on outcome of Intra
Cytoplasmic Sperm
Injection (ICSI)
in infertile PCOS women.
Methods: A randomized clinical trial study was carried
out in infertile women with PCOS, before ICSI,
referred to infertility clinic of Mirza
Koochackhan Hospital
of Tehran University
of Medical Science
Tehran, Iran,
between 2006 and 2008.
The patients were randomized in two groups of
metformin 500 mg Po,
three times daily, six weeks before the ICSI
cycle and placebo patients in each group were divided into BMI
<28 kg/m2 and BMI
&ge28 kg/m2.
Results: Of 52
study women 26(50%) were in metformin
group. mean age were 29.8±4.9 year in
metformin group versus 29.4±5.9 year and
placebo groups. Treatment with
metformin, in subgroup of BMI <28 kg/m2,
significantly increased number of mature follicle (p=0.01),
embryo (p=0.04),
oocytes (p=0.007)
and mature oocytes (p=0.03)
but in subgroup of BMI&ge28 kg/m2,
there was no significant difference in the metformin and placebo groups (p>0.05).
Metformin treatment caused more chemical and
clinical pregnancy rates, and less abortion rate in overweight and normal patients,
but the differences were not significant (p>0.05).
Logestic regression analysis showed, adjusting
number of mature follicle, number of embryos, quality of embryos, oocytes and BMI
and treatment showed no significant effect on clinical pregnancy
rates (p>0.05).
Conclusions: Among normal weight PCOS
women, effect of treatment with metformin is better than overweight PCOS
women. However further
studies are needed.
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