Comparison of metformin treatment and laparoscopic ovarian diathermy in patients with polycystic ovary syndrome

Objective: To compare hormone levels and clinical outcomes in patients with polycystic ovary syndrome (PCOS) after metformin therapy or laparoscopic ovarian diathermy (LOD) at 6 months follow-up. Methods: A randomized trial was conducted in 126 patients with PCOS who had a history of infertility for at least 1 year and resistance to clomiphene citrate (CC). Patients (n = 63) received metformin treatment or underwent LOD (n = 63). Results: Levels of follicle-stimulating hormone did not change in either group after the intervention (P>0.05). Serum levels of testosterone (P<0.001) and luteinizing hormone (P<0.001) were significantly lower after the treatment in both groups. The proportion of women with regular menstrual cycles increased significantly to 35% (P<0.001) in the LOD group and to 49% (P<0.001) in metformin group compared with before the intervention. Although proportion was higher in the metformin group compared with the LOD group, the difference was not significant (odds ratio 1.81; 95% CI, 0.88-3.69, P=0.1). Hirsutism decreased significantly from 100% to 79.37% (P<0.001) in both groups. Conclusion: CC-resistant patients with PCOS were treated effectively by both metformin and LOD. (C) 2009 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.