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Evidence-Based Medicine 2004; 9:85
© 2004 BMJ Publishing Group Ltd.

Therapeutics

Review: metformin used alone or combined with clomifene may improve ovulation rates in the polycystic ovary syndrome

Lord JM, Flight IH, Norman RJ. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ 2003;327:951–6.[Abstract/Free Full Text]
Lord JM, Flight IH, Norman RJ Insulin-sensitising drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome Cochrane Database Syst Rev 2003;(3):CD003053.

Q In women with the polycystic ovary syndrome (PCOS), what is the effectiveness of insulin sensitising drugs?

GP/FP/Primary care *****{star}{star} Gynaecology ******{star} Endocrine *****{star}{star}

Key Words: polycystic ovary syndrome • metformin • ovulation

The first 150 words of the full text of this article appear below.

METHODS
Data sources: the Cochrane Menstrual Disorders and Subfertility Group trials register (December 2002), the Cochrane Central Register of Controlled Trials (Cochrane Library, Issue 4, 2002), Medline (1966 to December 2002), and EMBASE/Excerpta Medica (1985 to December 2002); bibliographies of relevant studies; and pharmaceutical companies.

Study selection and assessment: randomised controlled trials (RCTs) that compared insulin sensitising drugs with placebo, no treatment, or an ovulation inducting agent in women with PCOS based on biochemical or ultrasonographic evidence. Studies were assessed for allocation concealment, blinding, loss to follow up, non-compliance, and intention to treat analysis.

Outcomes: clinical (including live birth rate, clinical pregnancy rate, spontaneous ovulation, menstrual cyclicity, and adverse pregnancy events) and biochemical outcomes.

MAIN RESULTS
15 RCTs (997 women) were included. 13 RCTs (n = 543) used metformin, 1 (n = 410) used troglitazone, and 1 (n = 44) used d-chiro-inositol. Blinding was present in all but 1 trial. Women had PCOS . . . [Full text of this article]

Kathleen M Hoeger, MD, David S Guzick, MD, PhD

University of Rochester School of Medicine and Dentistry
Rochester, New York, USA






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