Nasima M Siddiq, Asifa Ghazi, Shazia Jabbar, Nusrat H Khan.
Effects of Metformin therapy on PCO induced infertility & menstrual disturbances.
Pak J Surg Jan ;22(2):113-5.

Objective: To assess the efficacy of Metformin therapy in Polycystic Ovarian Disease (PCO) induced infertility and menstrual disturbances. Design & Duration: Prospective, observational study from 1.1.2002 to 31.12.2004. Setting: Infertility Clinic of the Dept. of Gynaecology & Obstetrics (Unit III), Civil Hospital, Karachi. Patients: 300 patients with PCO induced infertility and menstrual disturbances. Methodology: Out of 935 patients seen in the Infertility Clinic, 320 (32.09%) had PCO induced infertility. Their biodata, clinical features, investigations and follow-up were recorded on a proforma. These patients were started on Tab. Metformin (500mg) bid, which was generally increased to 500mg qid, and they were followed-up for a period of two years. Results: Out of the 320 patients with PCO, 260(81.25%) presented with oligmenorrhoea and other menstrual disturbances, 180 (56.25%) with obesity and 60 (18.75%) patients with hirsutism. Hyperinsulinaemia was also seen in 110 (34.38%) patients. As 20 cases were excluded due to follow-up loss, etc., hence finally 300 patients were left. The first positve response in them was seen within six weeks of Metformin therapy in the form of regular menstruation with moderate flow in 219 (73%), while weight reduction was observed in 60 (20%) and decrease in serum insulin levels in 90 (30%) patients. A total of 110 (36.67%) patients conceived between 12 weeks to one year of the therapy. Conception rate was more marked in those PCO patients who showed decrease in insulin levels and weight reduction between 2-20 Kg. Conclusion: Metformin therapy is effective in the treatment of oligomenorrhoea and PCO induced infertility, result being more pronounced in those cases who showed weight reduction and decrease in serum insulin levels.

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