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Hum. Reprod. Advance Access published online on October 28, 2004
Human Reproduction, doi:10.1093/humrep/deh580
© 2004 by European Society of Human Reproduction and Embryology
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Received November 6, 2003
Revised March 10, 2004
Accepted September 29, 2004

Article

Comparison of the effects of acarbose and metformin use on ovulation rates in clomiphene citrate-resistant polycystic ovary syndrome

A.S. Sönmez 1*, L. Yasar 1, K. Savan 1, S. Koç 1, J. Özcan 1, A. Toklar 1, F. Yazicioglu 1, A. Akgün 1, and N. Sut 2

1 Süleymaniye Maternity and Women's Disease Research and Teaching Hospital, Assisted Reproductive Techniques Unit, Cerrahpasa Medical School, Deparment of Biostatistics, Istanbul, Turkey
2 Istanbul University, Cerrahpasa Medical School, Deparment of Biostatistics, Istanbul, Turkey

* To whom correspondence should be addressed.
A.S. Sönmez, E-mail: suhas{at}net.net.tr


  Abstract

BACKGROUND: The aim of this study was to evaluate the effects of metformin and acarbose on insulin resistance, hormone profiles and ovulation rates in patients with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). METHODS: Thirty clomiphene citrate-resistant patients were selected randomly and divided into two groups. Group I was treated with 100 mg/day clomiphene citrate and 300 mg/day acarbose 100 mg/day orally, for 3 months. Group II was treated with clomiphene citrate 100 mg/day and metformin 1700 mg/day orally, for 3 months. Serum fasting insulin and glucose, FSH, LH, estradiol, progesterone, prolactin and total testosterone levels plus body mass index (BMI) were measured before and after treatment. Follicle growth was followed by transvaginal ultrasonography. RESULTS: LH:FSH ratio and total testosterone concentrations decreased (P<0.05) and ovulation rates increased in both groups. Reduction in weight and BMI was only significant in the acarbose group. CONCLUSIONS: Both treatment modalities were effective in the treatment of insulin resistance and improving ovulation rates. Increase in the number of eumenorrhoeic and normoinsulinaemic cases and decrease in the number of insulin-resistant cases were significant in both groups (P<0.05). Ovulation rate was greater in the metformin group in the second month of therapy (P<0.05). Acarbose was found to be a safe and effective agent that could be used in cases with clomiphene-resistant PCOS.

Keywords: acarbose; insulin resistance; metformin; polycystic ovary.
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