Which drugs are effective in treating anovulation in women with polycystic ovarian syndrome (PCOS)?

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Evidence suggests that metformin frequently, but not universally, improves ovulation rates and pregnancy rates in women with polycystic ovarian syndrome (PCOS), especially in obese women. [3, 4, 75] In addition, pretreatment with metformin has been shown to enhance the efficacy of clomiphene for inducing ovulation. [76] Consider the combination of metformin and clomiphene in older women with visceral obesity and clomiphene resistance. [3] However, this combination doesn’t significantly improve the live birth rate relative to clomiphene monotherapy. [3] Whether short-course metformin pretreatment (less than 4 weeks) is as effective as conventional long-course metformin remains uncertain. [6, 77]

A study found that N-acetylcysteine may enhance the effect of clomiphene citrate in inducing ovulation in patients with PCOS. [78]


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