Background; Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy in women that is associated with reproductive and metabolic disorders. Aim of the Work: To determine the effectiveness of short-course (four weeks) metformin plus CC versus long-course (eight weeks) with regard to ovulation and achievement of pregnancy in infertile women with PCOS. Patients and Methods: This is aprospective rondamized controlled trial of independent cases, conducted at Algalaa teaching hospital. 42 documented CC Resistant PCOS patients were divided to two groups, the first group(21 patients) received metformin for 4 weeks, the second group(21 patients) received metformin for 8 weeks ,both groups continued on metformin while receiving 50mg CC. twice daily staring from the third day of the cycle for 5 days for 3 succesive months. Main outcome: ovulation rate and ongoing pregnancy rate. Results: short course protocol achieved a cumulative rate of ovulation 76.2% (48 out of 63 cycles) while long course protocol achieved 71.4% (45out of 63 cycles), p-value 0.374. similary cum. Pregnancy rate was 42.85% (9out of 21) in short course group v.s 47.62%(10out of 21) p-value 0.757. Conclusion; both protocols of treatment are equally effective in treatment of infertility in CC-resistant patients with PCOS. Recommendations: Further studies on a larger scale of patients are needed to confirm the results obtained by this work. |
