The Negligible Effect of Metformin Addition to Letrozole in Treating Overweight Women with PCOS

Abstract

Aim: To compare the effects of letrozole alone and letrozole plus metformin on ovulation induction, endometrial thickness, number of ovarian follicles and, the pregnancy rate in overweight, infertile women with the polycystic ovarian syndrome. Study design: Prospective, randomized clinical trial. Material and methods: This study was conducted on 120 patients with polycystic ovarian syndrome, recruited from the infertility clinic of Tanta University Hospital, January 2017 to December 2019. Sixty women were assigned at random to each group. In a group, 1 patient received only daily 5 mg letrozole between days 3 and 7 of the menstrual cycle, and in group 2, continuous metformin was used at the dose of 500mg/TDS/day for three months; afterward, daily 5 mg letrozole between 3 and 7 days of the menstrual cycle was added to the metformin therapy. The patients were treated until pregnancy occurred, or three cycles were reached without pregnancy. Results: There was an insignificant increase in the cumulative pregnancy rate between the metformin-letrazole and the letrazole group. In the metformin-letrozole group, 28.33% of the patents got pregnant, compared with 25% of the patients in the letrazole group. There was no significant difference between the letrazole and the metforminletrazole group regarding ovulation rate, number of the follicle, endometrial thickness, and progesterone level. Conclusion: The addition of metformin to letrazole does not improve the outcome of overweight PCOS women.