Efficacy of Metformin in Obese Versus non-Obese Women with Polycystic Ovary Syndrome (PCOS)

Background: Polycystic Ovary Syndrome (PCOS) is a common cause of amenorrhea and infertility among women. Objectives: The study evaluated the efficacy of metformin in obese versus non-obese women with Polycystic Ovary Syndrome (PCOS). Methods: A quasi-experimental study was conducted at a tertiary care center between March 2018 to December 2021. All patients who presented with chronic anovulation with oligomenorrhea or amenorrhea and polycystic ovaries on ultrasound were included in the study. Women with hyperprolactinemia, pregnancy, or lactation were excluded. Non-obese participants were labeled as “Group A” while obese were labeled as “Group B”. Metformin therapy was initiated at an oral dose of 500 mg per day for the first week, followed by two times a day for another week. Ovulation and menstrual regularity were documented after six months of treatment. Metformin was considered effective if menstrual cycles were normalized and ovulation was achieved. Results: The efficacy of metformin was 83.15% in non-obese women while in obese women it was only 53.65% (p < 0.0001). The ovulation was more frequently achieved by non-obese women as compared to obese women [296 (83.15%) vs. 115 (32.3%); p < 0.0001]. In lean patients fasting serum insulin reduced from 9.7±3.4 mU/l vs. 6.2±3.8 mU/l, (p=0.032) while in obese patients, it changed from 20.2±10.2 mU/l vs. 14.4±3.2 mU/l (p