Razia Tarique Qureshi, Fouzia Rahim, Gulfreen Haidar.
POLYCYSTIC OVARIAN DISEASE; Impact of metformin on fertility in women.
Professional Med J Jan ;23(07):775-9.

Objectives: To determine the role of metformin in correcting the irregularity of menstrual periods and infertility due to PCO. Study Design: Descriptive observational study. Setting: Gynecology Department of PUMHS Nawabshah. Period: 4th February 2010 up to November 2011. Patients and methods: Total 329 patients had selected in this series, based on presence of PCO on ultrasound with 2 or extra following criteria like oligomenorrhea, hirsutism, hyperandrogenism and reversed FSH: LH ratio. Other endocrinal reasons of female infertility as Cushing syndrome, congenital adrenal hyperplasia, hyperprolectinemia and cases thyroid disorder had excluded. After detailed history, Metformin was started with dose of 250mg once a day initially then gradually adjusted to 500mg TD. Weight decreased was encouraged with diet and the exercise. Cases assessed after six months for checking regularity of their menstrual cycle, fertility and the BMI change. Cases those not be success to conceive following 6 months, than the ongoing criteria of clomiphene. Women those failed to conceive after uses of clomiphene citrate, than metformin alone was sustained and fertility had re evaluated on end of 1 year. Results: 329 cases had selected. Commonest menstrual irregularity was oligomenorrhea with hypo menorrhea which is seen in 46% of patients. After six months of metformin treatment 82% cases assessed improvement of menstrual cycle, while 13% still have oligomenorrhea. Results found significant (P<0.001) .BMI of all study patients was compared prior and then treatment and significant results were found (P <0.001). After six months for fertility analysis, complete data was available from 117 patients only. Overall fertility rate was 91.1%. Conclusion: Metformin is successful treatment of cases having PCOS.

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