1. l-Carnitine plus metformin in clomiphene-resistant obese PCOS women, reproductive and metabolic effects: a randomized clinical trial.
- Author
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El Sharkwy I and Sharaf El-Din M
- Subjects
- Adult, Blood Glucose drug effects, Blood Glucose metabolism, Female, Fertility Agents, Female therapeutic use, Hormones metabolism, Humans, Infertility, Female complications, Infertility, Female metabolism, Infertility, Female physiopathology, Insulin Resistance physiology, Obesity complications, Obesity metabolism, Obesity physiopathology, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome metabolism, Polycystic Ovary Syndrome physiopathology, Pregnancy, Pregnancy Rate, Reproduction drug effects, Treatment Outcome, Young Adult, Carnitine administration & dosage, Clomiphene therapeutic use, Drug Resistance drug effects, Infertility, Female drug therapy, Metformin administration & dosage, Obesity drug therapy, Polycystic Ovary Syndrome drug therapy
- Abstract
To evaluate the reproductive and metabolic effects of L-carnitine plus metformin in clomiphene citrate (CC) resistant obese polycystic ovary syndrome (PCOS) women. A double-blinded randomized controlled clinical trial, clomiphene-citrate resistant obese women were allocated randomly to receive CC plus metformin and L-carnitine ( n = 138) or CC plus metformin and placebo ( n = 136). The primary outcome was clinical pregnancy rate. The secondary outcomes were hormonal and metabolic profile changes in addition to ovulation and first trimester (13 weeks) miscarriage rates. Clomiphene-citrate, L-carnitine, and metformin group showed significant improvement in the menstrual regularity, ovulation rate, and pregnancy rate compared to CC plus metformin and placebo group (29% vs. 9%, 34.7% vs. 11%, and 28.2% vs. 6.6%, respectively). No statistically significant difference in the miscarriage rate between the two groups ( p = .08). After three months of treatment, the reduction in body mass index (BMI) was non-significant ( p = .061) between both groups. The hormonal and metabolic parameters were more significantly improved in the L-carnitine group compared with the placebo group. l-Carnitine may act synergistically with metformin for improvement of reproductive performance, insulin resistance, and lipid profile in clomiphene-resistant obese PCOS women.
- Published
- 2019
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