Comparative Study between Metformin and Laparoscopic Ovarian Drilling for Ovulation Induction, Achievement of Pregnancy and Live Birth in Asian Women with Polycystic Ovarian Syndrome: A Prospective Trial

摘要

Objective: To compare the efficacy of metformin and laparoscopic ovarian drilling to be used in anovulatory patients with polycystic ovarian syndrome (PCOS) for ovulation induction and pregnancy achievement. Materials and Methods: Setting and Design: A prospective clinical trial conducted in the outpatient department of Gynaecology and Obstetrics of BIRDEM hospital from August 2008 to August 2013. Patient(s): Three hundred and eight newly diagnosed patients with PCOS based on ESHRE/ASRM criteria. These patients were assigned to two groups: Group 1 (152 patients) received 500 mg of metformin three times a day; Group 2 (156 patients) received laparoscopic ovarian drilling. Main Outcome Measure(s): Rate of ovulation, pregnancy rate (PR), and live birth. Ovulation was monitored by serum progesterone, transvaginal sonography up to six cycles or till pregnancy occurred upto six months. Result(s): The ovulation rate was 68.4% in the metformin group, 59% in the laparoscopy treatment group. The pregnancy rate was (20.1% and 16.6%) and live birth rate was (18.4% and 15.4%) in metformin and laparoscopy treatment groups, respectively. The rate of spontaneous first trimester loss was three and two in metformin and laparoscopy group respectively. There were no ectopic pregnancies in metformin group and two in laparoscopy group. There was no second trimester pregnancy loss in metformin group, three in laparoscopy group. There were no multiple pregnancies in metformin group, two in laparoscopy group.