Retracted: Metformin versus laparoscopic ovarian drilling in clomiphene‐ and insulin‐resistant women with polycystic ovary syndrome
Abstract
Objective: To compare the hormonal‐metabolic profiles and reproductive outcomes in clomiphene‐resistant patients with polycystic ovary syndrome and insulin resistance between women receiving metformin and those undergoing laparoscopic ovarian drilling. Methods: A total of 110 eligible participants were randomly allocated to diagnostic laparoscopy plus metformin therapy (group 1, n = 55) or laparoscopic ovarian drilling (group 2, n = 55). The t test was used for mean comparisons of hormonal‐metabolic parameters and OGTT values before and after treatment. The χ 2 test was used for comparisons of ovulation, pregnancy, and abortion rates. Results: Groups 1 and 2 showed a significant decline in testosterone, insulin‐like growth factor‐1 (P < 0.001 vs P < 0.001), and luteinizing hormone (P < 0.05 vs P < 0.001), while the glucose to insulin ratio was significantly increased (P < 0.001 vs P < 0.05) compared with baseline. Group 2 patients had more regular cycles and higher rates of ovulation and pregnancy compared with group 1: 76.4% [42/55] vs 58.2% [32/55], P < 0.04; 50.8% [131/258] vs 33.5% [94/281], P < 0.001; and 38.2% [21/55] vs 20.0% [11/55], P < 0.03, respectively. The difference in the early abortion rate between the groups was not statistically significant. Conclusion: Although metformin results in a better attenuation of insulin resistance, laparoscopic ovarian drilling is associated with higher rates of ovulation and pregnancy.
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Two medium-quality RCTs with moderate risk of bias found insufficient evidence to recommend laparoscopic ovarian surgery compared with metformin for live birth rate per patient, ovulation or pregnancy rate per cycle, pregnancy rate per patient and miscarriage rate per pregnancy.
“Two medium-quality RCTs (level II) with moderate risk of bias found insufficient evidence to recommend laparoscopic ovarian surgery compared with metformin for live birth rate per patient, ovulation or pregnancy rate per cycle, pregnancy rate per patient and miscarriage rate per pregnancy. 257-259”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [257]
There was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over either metformin or clomiphene citrate alone, or clomiphene citrate plus metformin, for multiple pregnancies, and for adverse effects and QoL.
“There was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over either metformin or clomiphene citrate alone, or clomiphene citrate plus metformin, for multiple pregnancies, 257,260 and there was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over any intervention for adverse effects and QoL.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [257]
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References 27 · Cited by 41
- Authors
- Hamed, H. O., Hasan, A. F., Ahmed, O. G., & Ahmed, M. A.
- Affiliations
- Assiut University (EG)
- Corresponding author
- Hamed, Hossam O.
- Venue
- International Journal of Gynecology & Obstetrics
- Publisher
- Wiley
- Published
- 2009-11-04
- Volume
- 108
- Issue
- 2
- Pages
- 143-147
- ISSN
- 0020-6695 (ISSN-L)
- 0020-7292
- 1879-3479
- OpenAlex
- W2158665532
- Cited by
- 41
- References
- 27
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 3 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 4 · 2015: 5 · 2014: 2 · 2013: 7 · 2012: 4
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Status
- Retracted
- Update notices
- retraction (2023-06-26)
- Open access
- closed
- Locations
- International Journal of Gynecology & Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- metformin, laparoscopic ovarian drilling, polycystic ovary syndrome, insulin resistance, clomiphene citrate resistance, ovulation induction, pregnancy rate, first-trimester abortion, insulin-like growth factor I, luteinizing hormone, testosterone
- MeSH terms
- Adult, Clomiphene, Female, Fertility Agents, Female, Hormones, Humans, Hypoglycemic Agents, Insulin Resistance, Metformin, Laparoscopy, Polycystic Ovary Syndrome, Pregnancy, Pregnancy Rate, Young Adult
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