Abstract: P-366

The Addition of Metformin During Ovulation Induction with Letrozole Does Not Affect Pregnancy Outcome in Infertile Women with Polycystic Ovary Syndrome.

Presenter: Emily Hurley


Abstract


OBJECTIVE: Previous research has demonstrated no difference in live-birth rate in infertile women with polycystic ovary syndrome (PCOS) when comparing those using clomiphene citrate (CC) and metformin to matched controls using CC alone. Because letrozole (LE) is associated with higher live-birth and ovulation rates in PCOS patients, it has become the first line of treatment for this patient population. view more

OBJECTIVE: Previous research has demonstrated no difference in live-birth rate in infertile women with polycystic ovary syndrome (PCOS) when comparing those using clomiphene citrate (CC) and metformin to matched controls using CC alone. Because letrozole (LE) is associated with higher live-birth and ovulation rates in PCOS patients, it has become the first line of treatment for this patient population. The aim of this study is to investigate if the addition of metformin improves follicular recruitment and pregnancy rates in ovulation induction cycles with intrauterine insemination (OI/IUI) in infertile PCOS women using LE.
DESIGN: Retrospective chart review
MATERIALS AND METHODS: All OI/IUI cycles from January 2012 to August 2016 utilizing letrozole treatment were reviewed. A total of 268 OI/IUI cycles with a diagnosis of PCOS were included. Demographics (age, body mass index (BMI)), LE dose, metformin use, number of mature follicles, size of lead follicle and pregnancy outcomes were collected. Results were compared based on whether the patient was taking letrozole and metformin (LE-M) versus letrozole only (LE). Graphpad Prism 6.0 was used to analyze the data. Descriptive data was analyzed as percentages and means with standard deviations. Statistical differences between groups were determined using Fisher’s exact and chi-square with a p-value <0.05 considered significant.
RESULTS: A total of 268 OI/IUI cycles were analyzed, of which 159 received LE-M and 109 received LE. There were no significant differences in age, AMH or BMI when comparing the two groups. There were no statistical differences in follicular recruitment (1.5 + 0.8 versus 1.6 + 0.8, p=0.8939) or pregnancy rates (10% versus 13%, p=0.5663) when comparing the LE-M versus LE groups, respectively.
CONCLUSIONS: The addition of metformin to LE does not improve follicular recruitment or pregnancy rates in OI/IUI cycles in infertile PCOS women.

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