Abstract
Objective: To compare the efficacy of clomiphene citrate alone and with metformin for the treatment of infertility in known cases of polycystic ovarian syndrome (PCOS).
Methodology: It was a randomized controlled trial conducted at department of Gynecology and Obstetrics, Cantonment General Hospital, Rawalpindi, Pakistan from July 2015 to December 2015. Total of 128 patients were selected and divided into two groups, each with 64 patients. The inclusion criteria were age between 20-35 years and duration of infertility three years or less, patients who were already diagnosed as case of PCOS. Group A, was offered Clomiphene Citrate alone and Group B was offered Clomiphene Citrate in combination with Metformin for ovulation induction. We gave ovulation induction in both groups for three consecutive cycles. Conception results were compared in both groups. Conception was confirmed by urine for pregnancy test and pelvic ultrasonography.
Results: The mean age of group A was 28.67±2.67 years and mean age of group B was 28.55±2.39 years, both range from 24 to 34 years (P>0.05) which is almost equal in both groups. The mean duration of marriage in Group A was 3.89±1.89 years (range 2 to 8) and mean duration of marriage in Group B was 3.19±1.837 years, (range 1 to 8). In Group A after three cycles total number of patients conceived were10 and in group B, 23 patients had conceived.
Conclusions: Number of patients who conceived with combination of drugs is more because of decreasing insulin resistance but in comparison to clomiphene alone it is not statistically significant. Hence, proving that combination of Clomiphene and Metformin is not better than Clomiphene alone.

Key words: Ovulation induction, Conception, PCOS