Metformin vs. Clomiphene in Women with PCOS

Despite evidence that metformin — either alone or in combination with clomiphene citrate — seems no more effective than clomiphene alone for inducing ovulation in women with polycystic ovary syndrome (PCOS), many clinicians continue to favor its use. Investigators in New Zealand conducted a multicenter randomized trial to evaluate whether metformin is beneficial in treating women with anovulatory PCOS. Participants with body-mass index (BMI) >32 kg/m² received placebo or metformin (1500 mg daily; in both groups, clomiphene was added after 3 months if ovulation was not achieved) and those with BMI ≤32 kg/m² received clomiphene (50–150 mg daily for 5 days), metformin, or both. Each of the five groups contained 32 to 36 participants; treatment…