Status of clomiphene citrate and metformin for infertility in PCOS

被引:44
作者
Misso, Marie L. [1 ,2 ]
Teede, Helena J. [1 ,2 ,3 ]
Hart, Roger [4 ,5 ]
Wong, Jennifer [1 ,3 ]
Rombauts, Luk [6 ]
Melder, Angela M. [7 ]
Norman, Robert J. [8 ,9 ]
Costello, Michael F. [10 ,11 ,12 ]
机构
[1] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3168, Australia
[2] Jean Hailes Womens Hlth, Melbourne, Vic 3168, Australia
[3] So Hlth, Dept Endocrinol & Diabet, Melbourne, Vic 3168, Australia
[4] Univ Western Australia, Sch Womens & Infants Hlth, Perth, WA 6008, Australia
[5] Fertil Specialists Western Australia, Perth, WA 6010, Australia
[6] Monash Univ, Dept Obstet & Gynaecol, Melbourne, Vic 3168, Australia
[7] So Hlth, Ctr Clin Effectiveness, Melbourne, Vic 3168, Australia
[8] Univ Adelaide, Robinson Inst, Sch Paediat & Reprod Hlth, Adelaide, SA 5000, Australia
[9] Fertility SA, Adelaide, SA 5000, Australia
[10] Univ New S Wales, Sydney, NSW 2000, Australia
[11] Royal Hosp Women, Dept Reprod Med, Sydney, NSW 2000, Australia
[12] IVF Australia, Sydney, NSW 2000, Australia
关键词
clomiphene citrate; metformin; polycystic ovary syndrome; ovulation induction; infertility; systematic review; POLYCYSTIC-OVARY-SYNDROME; INSULIN-RESISTANCE; OVULATION INDUCTION; WOMEN; PREVALENCE; MANAGEMENT;
D O I
10.1016/j.tem.2012.07.001
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Though widely used, there is uncertainty about the effectiveness and adverse effects of metformin and clomiphene citrate (CC) for infertility in polycystic ovary syndrome (PCOS). A systematic review (SR) of the best available evidence suggests that both CC and metformin are better than placebo for increasing ovulation and pregnancy rates, but CC is more effective than metformin for ovulation, pregnancy and live-birth rates, in PCOS patients with body mass index (BMI) >30. A combination of CC and metformin is superior to either metformin alone or CC alone, depending on the BMI and CC sensitivity of the patient. This SR provides key messages to guide clinicians and consumers on the use of these interventions in different subgroups of women with PCOS.
引用
收藏
页码:533 / 543
页数:11
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