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Polycystic ovary syndrome (PCOS), characterized by hyperandrogenemia and oligomenorrhea and associated with the metabolic syndrome and insulin resistance, is a common cause of infertility. Insulin sensitizers constitute one recommended treatment; metformin has been reported to increase ovulation rates in obese, infertile women with PCOS, but clomiphene citrate is more commonly used to induce ovulation.
In this trial, investigators with the NIH’s Reproductive Medicine Network randomized 626 infertile women with PCOS to receive extended-release metformin, clomiphene citrate, or a combination of both therapies; live birth was the primary outcome. Participants (average body-mass index, about 35) were treated for up to 6 months, with therapy disc…