OUTCOME OF OVULATION INDUCTION WITH CLOMIPHENE CITRATE VERSUS COMBINED CLOMIPHENE CITRATE AND METFORMIN AT SAAD ABU ELELLA UNIVERSITY HOSPITAL

Abstract

Abstract

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Although Clomiphene Citrate (CC) is an available standard ovulation induction treatment, combination therapy with Metformin will be more effective in treating insulin-resistant cases. Nevertheless, the effects of this combination on ovulation and pregnancy success are unknown.

Objective: To assess whether the addition of Metformin to CC in women with PCOS improves ovulation rate.

Methods: This prospective clinical trial included 81 women with PCOS-related infertility which was defined according to the Rotterdam criteria. Two groups, CC alone (n=42) or CC and Metformin (n=39), were assigned. Ovulation rates, follicular development and pregnancy outcomes were assessed by transvaginal ultrasound and relevant hormonal tests.

Results: The CC plus Metformin group showed significantly higher ovulation rates (79.5% vs. 54.8%, p=0.018) and pregnancy rates (30.8% vs. 9.5%, p=0.016) compared to the CC-only group. No cases of ovarian hyperstimulation were observed.

Conclusion: For Sudanese women with PCOS, combining metformin with CC could significantly improve their chances of ovulation and pregnancy. This approach may offer a valuable first-line treatment option, especially in regions where advanced fertility treatments are limited.