New study: Metformin more effective than Clomid

:

---

Metformin Increases Ovulation in Women with Polycystic Ovary Syndrome Better than Clomiphene Citrate: Presented at ASRM
By Amanda Strong

MONTREAL, QC -- October 21, 2005 -- Metformin is more effective than clomiphene citrate (CC) for ovulation induction in women with polycystic ovary syndrome (PCOS) and achieves equivalent pregnancy rates, according to a poster presented here on October 18th at the annual meeting of the American Society of Reproductive Medicine (ASRM).

"Both metformin and CC are being used for ovulation induction, but they have never been compared head to head," said lead author Nathalie Neveu, MD, Clinical Research Fellow, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.

The study involved 154 women who were referred to a fertility clinic for treatment of PCOS and infertility. The women were stratified according to whether they had initially been prescribed 50 mg of CC between days 5 and 9 of the cycle, 500 mg of metformin 3 times daily, or a combination of the two, for induction of ovulation.

Although metformin was more likely to have been prescribed for women with a higher body mass index (BMI), women given metformin alone had an increased ovulation rate compared with those given CC alone (75.4% versus 50%, respectively; P = .005).

No benefit for ovulation induction was observed in women given the combination of the two drugs, compared with women receiving metformin alone.

When the researchers excluded women with morbid obesity (BMI>40) from the analysis, the difference in BMI among the three treatment groups was no longer significant (P = .111). However, the ovulation rate was still significantly higher in the metformin group compared to the CC group (P = .029). Pregnancy rates were equivalent across all three groups (35.7%, 45.6% and 31.7% for Groups 1, 2, and 3, respectively; P = .0.332).

The results of the study suggest that metformin should be offered first-line for ovulation induction in all women with PCOS, the authors concluded.

"Metformin, considering all its beneficial effects on the metabolism, is a better option than clomipherate citrate, which also has negative effects on the endometrium," Dr. Neveu said.

---

hmm... very interesting. Don't know my BMI, but I was weighing 60kg (had just reached my ideal weight from being underweight). Metformin (2x500mg) got my cycle started within 6 weeks, and I was pg on my 2nd cycle. No need for Clomiphene, which both me and my OB were happy about. Neither of us wanted to risk multiples :)

Isn't that funny. For me Met alone didn't work, but I couldn't sustain a pregnancy without met (and astrix). Clomid worked like a charm for me, I conceived 3 times, but miscarried twice due to the first time my met was all over the place the second time same thing, and the third time I was very strict with my met and was on astrix and it worked!

*hugs*
Cailin

For me, clomid alone (and in conjunction with Met) didn't work. Met alone worked for me first month I was on it! My BMI was within range, too, so my doc didn't actually want to put me on Met (as told me it wouldn't work). I just think Met should be the first thing to try, after all Clomid has a big failure rate as well as increased risk for multiple births.

I agree with that one too! I think met should always be the go, and I think met should be prescribed either way as it can help with other symptoms of PCOS like weight etc and help sustain a pregnancy too. I plan to go back on met as soon as this bubba is born. I was on met for about 6 mths I think before we started on clomid. So my gyn definitely prescribes to this method too.

*hugs*
Cailin

Hmm ... this is good to know, since I'm having an ultrasound/hsg tomorrow to confirm a diagnosis of PCOS. My next appointment with the specialist is on 4th November, and she'd previously discussed the possibility of clomid, so I might ask her about this.

I was on Clomid for 2 cycles and I O both times and fell pregnant second cycle.My OB only ever offered the Clomid as he said Metformin was for more beneficial in overweight women.Goes to show how much he knew and that obviously no studies had been done.Would have preferred Metformin to as boy did clomid make me crazy!

My OB didn't think twice about prescribing metformin for me. I've mostly been underweight, and ideal weight.

But I think it's a fairly new thing for them to be using it to treat PCOS. I have friends who work in pharmacies, and they've spoken to the pharmacists about it, and they've never heard of it being used for this, and when I filled my last prescription, I said "phew, my last lot of metformin" and the pharmacist looked concerned and asked why I'd be stopping it. I had to explain the whole thing to him!! hehehe. He must have thought I was on it as a diabetic, and couldn't understand why I'd be stopping. (I took metformin up until my 12th week :) )

Thanks for posting that article Sal!and with all the girls chatting about their experiences its been very inspirational ...