Therapeutic effects of metformin and clomiphene in combination with lifestyle intervention on infertility in women with obese polycystic ovary syndrome

Jing Zhang,Jinqiong Li,Qinqin Si

doi:10.12669/pjms.331.11764

Abstract

Objective:To evaluate the therapeutic effects of metformin and clomiphene in combination with lifestyle adjustment on infertility in women with obese polycystic ovarian syndrome (PCOS).Methods:A total of 101 infertile women with obese PCOS admitted to our hospital from July 2013 to July 2015 were randomly divided into an observation group (n=51) and a control group (n=50). The control group was treated with metformin plus clomiphene, based on which the observation group was also subjected to lifestyle adjustment. The body weight, body mass index (BMI) and waist-to-hip ratio (WHR) were measured before and after treatment. The changes of reproductive hormones, ovaries and endometrium were detected, and the rates of menstrual recovery, ovulation and pregnancy were observed.Results:The body weight and BMI of the observation group after treatment were significantly lower than those before treatment and of the control group (P<0.05). There was no significant difference in WHR between the two groups. In the observation group, there were significant differences in LH, T, LH/FSH, FINS and TG levels before and after treatment and from those of the control group after treatment (P<0.05). Both the left and right ovarian volumes of the observation group after treatment were significantly lower than those before treatment and of the control group after treatment (P<0.05). The menstrual recovery, ovulation and pregnancy rates of the observation group were significantly higher than those of the control group (P<0.05).Conclusion:Lifestyle adjustment combined with metformin and clomiphene can improve the reproductive endocrine and lipid metabolism of obese PCOS patients, decrease the volumes of left and right ovaries, and increase the menstrual recovery, ovulation and pregnancy rates.

Highlights

Polycystic ovarian syndrome (PCOS) is an endocrine disorder with coexisting glucose metabolism abnormalities and reproductive dysfunction, with complex clinical symptoms as well as unclear etiology and pathogenesis
PCOS is clinically typified by androgen excess and chronic anovulation, manifested as menstrual disorders, hypomenorrhea, amenorrhea, obesity, infertility, hirsutism, acne, etc
The observation group received lifestyle adjustment on the basis of the control group: Low-fat diet: Carbohydrates mainly included oats and ordinary Japanese rice, with oil intake limited and fat and fried foods avoided; proteins were mainly derived from plants, fish and shrimp

Summary

Introduction

Polycystic ovarian syndrome (PCOS) is an endocrine disorder with coexisting glucose metabolism abnormalities and reproductive dysfunction, with complex clinical symptoms as well as unclear etiology and pathogenesis. PCOS has mainly been associated with adrenal dysfunction, hypothalamic-pituitary dysfunction,[1] insulin resistance, genetic factors, etc. Treatment of infertile women with obese polycystic ovary syndrome the disease is often complicated by metabolic abnormalities of other tissues, increasing the risk of cardiovascular diseases and endometrial cancer. The life, mental and physical healths of patients are severely affected. PCOS is generally clinical treated by taking oral contraceptives and insulin, but the therapeutic effects remain unsatisfactory.[2] This study assessed the effects of metformin and clomiphene in combination with lifestyle adjustment on infertility in obese PCOS patients by observing the changes of reproductive endocrine and lipid metabolism

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Results

Conclusion