Publication:

Effects of calcium-vitamin D and metformin on the menstrual cycle and ovulation in polycystic ovary syndrome patients in a tertiary care teaching hospital

Background Polycystic ovary syndrome (PCOS) is a heterogeneous hormonal disorder of reproductive aged women characterized by chronic anovulation, irregular menstrual cycles and hyperandrogenism. The present study aimed to investigate the effects of metformin and calcium-vitamin D on follicular maturation and regularity of menstrual cycles in patients with PCOS.

Methods A prospective, open-label, multiple arms, randomized clinical trial. Group 1 participants received 1,000 mg of calcium and 400 IU of vitamin D per day, orally, group 2 participants received 1,500 mg of metformin per day, orally and group 3 participants received combination of above drugs. The patients were treated for 3 months and followed up for a further 3 months. Menses regularity, number of dominant follicles (≥14 mm) and pregnancy rates were compared among the three groups.

Results A total of sixty infertile women with PCOS were recruited. Calcium-vitamin D plus metformin treated patients showed highest percentage improvement (50%) menstrual regularity as compared to other two groups (p<0.001) also showed significant follicular response (p<0.014). Calcium-vitamin D plus metformin treated group showed better follicular response in the second and third month of follow-up and 30% of women showed high quality dominant large (≥14 mm) follicles at the end of follow-up period.

Conclusions Calcium-vitamin D plus metformin combination is more effective in terms of follicle maturation and restoring menstrual disturbances as compared to individual drug treatment.