An assessment of lifestyle modification versus medical treatment with clomiphene citrate, metformin, and clomiphene citrate–metformin in patients with polycystic ovary syndrome
Received 22 October 2008; received in revised form 12 February 2009; accepted 25 February 2009. published online 21 May 2009.
Objective
To compare the effect of clomiphene citrate, metformin, and lifestyle modification on treatment of patients with polycystic ovary syndrome (PCOS).
Design
Prospective randomized double-blind study.
Setting
University-based infertility clinic and research center.
Patient(s)
Three hundred forty-three overweight infertile women with PCOS.
Intervention(s)
The participating women were assigned to four groups: clomiphene (n = 90), metformin (n = 90), clomiphene + metformin (n = 88), and lifestyle modification (n = 75). The patients in each group received standardized dietary and exercise advice from a dietitian.
Main Outcome Measure(s)
The primary outcome variables were change in menstrual cycle, waist circumference measurements, endocrine parameters, and lipid profile. The main secondary outcome variable was clinical pregnancy rate.
Result(s)
The clinical pregnancy rate was 12.2% in clomiphene group, 14.4% in metformin group, 14.8% in clomiphene + metformin group, and 20% in lifestyle modification group. Lifestyle modification group achieved a significant reduction in waist circumference, total androgen, and lipid profile.
Conclusion(s)
Lifestyle modification improves the lipid profile in PCOS patients. Therefore, lifestyle modification may be used as the first line of ovulation induction in PCOS patients.
Research and Clinical Center for Infertility, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Reprint requests: Mohammad Ali Karimzadeh, Research and Clinical Center for Infertility, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran (FAX: +98 351 8247087).
M.A.K. has nothing to disclose. M.J. has nothing to disclose.
ABSTRACT