Usporedba dugotrajne i kratkotrajne terapije metforminom i klomifen citratom za indukciju ovulacije u žena sa sindromom policističnih jajnika
Abstract
Background
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among reproductive‐aged women. Apart from infertility, women with PCOS often have other endocrine disorders, including insulin resistance, hyperinsulinaemia and hyperandrogenism. Metformin,combined with clomiphene citrate (CC), has been shown to be more effective in ovulation induction when compared with clomiphene citrate alone. The optimal duration for metformin pretreatment before initiation of clomiphene citrate, however, is unknown.
Objectives
To determine the effectiveness of short‐course (less than four weeks) metformin plus CC versus long‐course (four weeks or more) metformin plus CC with regard to ovulation and achievement of pregnancy in infertile women with PCOS.
Search methods
We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMBASE and PsycINFO (all from inception to 1 February 2012).
Selection criteria
Randomised controlled trials comparing short‐course (less than four weeks) metformin plus CC versus long‐course (four weeks or more) metformin plus CC for ovulation or achievement of pregnancy in infertile women with PCOS.
Data collection and analysis
No trials were found that met the selection criteria.
Main results
No randomised controlled trials were identified.
Authors' conclusions
There are insufficient data to determine whether short‐course metformin pretreatment is as effective as the conventional long‐course metformin pretreatment before initiation of clomiphene citrate for ovulation induction in infertile women with PCOS. A well‐designed randomised controlled trial is needed to answer this important clinical question.
Laički sažetak
Usporedba dugotrajne i kratkotrajne terapije metforminom i klomifen citratom za indukciju ovulacije u žena sa sindromom policističnih jajnika
Sindrom policističnih jajnika (PCOS) je najčešća bolest hormonskog sustava (endokrinopatija) među ženama reproduktivne dobi. Osim neplodnosti, žene s PCOS često imaju i druge hormonske (endokrine) poremećaje, uključujući rezistenciju na inzulin, hiperinzulinemiju i hiperandrogenizam. Kombinacija metformina i klomifen citrata se pokazala učinkovitija u indukciji ovulacije od samog klomifen citrata. Međutim, nepoznato je optimalno trajanje terapije metforminom prije uvođenja klomifen citrata. Nije bilo provedenih studija koje bi utvrdile učinkovitost kratkotrajne terapije (kraće od četiri tjedana) metforminom i klomifen citratom u usporedbi s konvencionalnom dugotrajnom terapijom ( četiri i više tjedana) metforminom i klomifen citratom s obzirom na ovulaciju i postignuće trudnoće u neplodnih žena sa sindromom policističnih jajnika.
