Jahan Ara Hasan, Ghufrana Umer Memon.
Impact of Metformin therapy in patients with polycystic ovarian syndrome.
J Coll Physicians Surg Pak Jan ;15(11):712-5.

Objective: To determine the effect of metformin therapy in achieving menstrual regularity, pregnancy, reducing obesity and hyperinsulinemia in patients with polycystic ovarian syndrome (PCOS). Design: Interventional, quasi-experimental study. Place and Duration of Study: Civil Hospital, Karachi from January 2002 to December 2003. Patients and Methods: Thirty patients with PCOS diagnosed on clinical symptoms, ultrasound examination and hormonal assays were selected. All patients either had raised serum fasting insulin levels or fasting blood sugar/serum fasting insulin ratio of < 4:5. Patients were then given treatment with Metformin 500 mg TID and continued for six months. The patients were called back for follow-up on monthly basis and clinical and bio-chemical variables were recorded on a proforma at 3 months and 6 months of initiating metformin treatment. The chi-square test was done and p-value determined to assess the outcome. Results: Significant effect of metformin therapy was observed at 3 months follow-up visit, 5 (16.7%) women achieved pregnancy while 20 (66.6%) women had a regular menstrual cycle (p = 0.001), and a significant reduction in weight (67.4 vs. 65.4, p = 0.001) and hyperinsulinemia (FBS: FI = 3.34 vs. 6.63, p = 0.001) was noted. After 6 months follow-up visit, 25 women were examined. Of these, 7 (28%) achieved pregnancy while 16 (64%) had regular menstrual cycle (p = 0.001) and a significant reduction in weight and hyperinsulinemia (p = 0.001). Conclusion: Metformin is very effective in achieving menstrual regularity, ovulation and pregnancy in patients with polycystic ovarian syndrome.

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