Cited by 33Ovarian function and disordersReproductive Health and TechnologiesEndometriosis Research and Treatment

Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second‐line strategy for infertile anovulatory patients with polycystic ovary syndrome: a randomized controlled trial

Palomba, Stefano, Falbo, Angela, Battista, Lucia, Russo, Tiziana, Venturella, Roberta, Tolino, Achille, Orio, Francesco, Zullo, Fulvio·2010·American Journal of Obstetrics and Gynecology

Abstract

Objective The purpose of this study was to compare the effectiveness of laparoscopic ovarian diathermy (LOD) vs clomiphene citrate (CC) plus metformin in infertile patients with CC-resistant polycystic ovary syndrome (PCOS).Study design Fifty primary infertile patients with CC-resistant PCOS were assigned randomly to receive LOD followed by a 6-month observation (group A) or 6-cycle course of CC plus metformin (group B). Reproductive and safety outcomes were analyzed.Results No significant difference between 2 groups in pregnancy (15/92 women [16.3%] vs 14/107 women [13.1%]; P = .521) and live-birth (13/92 women [14.1%] vs 12/107 women [11.2%]; P = .536) rates per cycle was observed. With the use of a Cox regression analysis, patients under medical treatment, compared with patients who received surgical treatment, had a relative risk of pregnancy of 1.2 (95% confidence interval, 0.61-2.44; P = .582) and a relative risk of live-birth of 1.4 (95% confidence interval, 0.63-2.96; P = .425).Conclusion LOD and CC plus metformin seem to be 2 effective approaches to treat infertility in patients with CC-resistant PCOS.

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Crossref · 10.1016/j.ajog.2009.11.042

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  • One high-quality RCT with low risk of bias found clomiphene citrate plus metformin was better than laparoscopic ovarian surgery for ovulation rate per cycle (P=0.02), but there was no difference for live birth rate, pregnancy rate per cycle and miscarriage rate per pregnancy.

    “One high-quality RCT (level II) with a low risk of bias found that clomiphene citrate plus metformin was better than laparoscopic ovarian surgery for ovulation rate per cycle ( P =0.02), but there was no difference for live birth rate, pregnancy rate per cycle and miscarriage rate per pregnancy. 256”

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Authors
Palomba, S., Falbo, A., Battista, L., Russo, T., Venturella, R., Tolino, A., Orio, F., & Zullo, F.
Affiliations
  • Magna Graecia University (IT)
  • Federico II University Hospital (IT)
  • Parthenope University of Naples (IT)
Corresponding author
Palomba, Stefano
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2010-06
Volume
202
Issue
6
Pages
577.e1-577.e8
ISSN
0002-9378 (ISSN-L)
OpenAlex
W2055814246
Cited by
33
References
41
Citations by year
2025: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 6
FWCI
5.31
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Keywords
clomiphene citrate, metformin, polycystic ovary syndrome, anovulatory infertility, pregnancy rate, live birth rate, surgical versus medical treatment
MeSH terms
Abortion, Spontaneous, Anovulation, Clomiphene, Diathermy, Drug Therapy, Combination, Female, Fertility Agents, Female, Humans, Hypoglycemic Agents, Infertility, Female, Metformin, Ovary, Ovulation Induction, Laparoscopy, Polycystic Ovary Syndrome, Pregnancy, Surveys and Questionnaires, Body Mass Index, Treatment Outcome, Patient Selection, Live Birth

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