Meta-Analysis Of The Ovulation Induction Of Metformin And Clomiphene Used In Dependently Or In Combination For The Treatment Of Patients With Polycystic Ovary Syndrome (PCOS)

OBJECTIVE:To systematically review the clinical ovulation induction of MET and CC used independently or in combination for the treatment of polycystic ovary syndrome (PCOS) in female patients.METHODS:We searched the PubMed, EMbase, CBMdisc, CNKI, VIP, Wanfang Database, and Chinese Biomedical Literature Database amongst other databases, and manual searching of relevant specialized medical magazines. We collected randomized controlled clinical trials (Randomized controlled trial, RCT) where MET and CC was used for the treatment of infertile women with PCOS before October 2014, the languages was not limited.According to the exclusion and inclusion criteria based on the Cochrane systematic review method, depend on included trials, extracted data, evaluated the risk of bias in the included studies and extracted relevant data. Meta-analysis was performed with RevMan 5.2(Computer program).RESULTS:A total of 1836 documents were detected. After excluding 1826 documents in the form of duplicates, non-related information, reviews, non-RCT, and incorrect randomized method,10 RCT containing/involving 1580 patients were included. Among which there were five RCT comparing MET and CC which included 837 cases of patients; there were 9 RCT that included the comparison of CC and CC+ MET consisting of 1100 cases of patients; and there were 4 RCT comparing MET and MET+CC, with a total of 741 patients. The Meta-analysis showed that: ① The periodic ovulation rate of CC was higher than that of MET. There was no significant difference in the pregnancy rate,live birth rate,multiple pregnancy rate and abortion rate between CC and MET. ② When compared with MET, there was a higher ovulation rate per cycle in CC+ MET group, a similar in pregnancy rate，live birth rate,abortion rate and multiple pregnancy rate.③ When compared with CC, there was a higher ovulation rate per cycle and pregnancy rate in CC+ MET group, a similar live birth rate、abortion rate and multiple pregnancy rate,and the value of FINS、 T、LH decreased more significantly in CC+ MET group, FSH value was no difference.CONCLUSION:combination with MET and CC used for PCOS patients can not only increase ovulation rate、pregnancy rate,but also can significantly reduce serum FINS value, T values, LH value level, and does not increase the risk of multiple pregnancy and abortion rate. Because each trial included study population is not exactly the same, so more high-quality, multi-center, large sample of randomized controlled trials are needed to determine the best treatment in the future.