Sylvy Medtasya Dzykryanka, Yulistani Yulistani, Budi Santoso

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PCOS is an ovarian dysfunction syndrome which characterized by the present of unovulation, hyperandrogenism, and polycystic ovarian morphology. The main cause of PCOS is still unclear, but many studies report that genetic factor have a great role. There are also two big concept in PCOS, hyperandrogenism and insulin resistance. Previous research by Ayaz et al (2013) has shown that metformin was given if there has been a resistance of clomiphene citrate. This study was designed to provide metformin and clomiphene citrate combination from the early administration to determine the effectiveness of the combination therapy. The objective of this study is to analyze HOMA-IR value, follicle size, and estradiol concentration after metformin and clomiphene citrate treatment in PCOS patient. Design of this study was an observational longitudinal prospective method. There was only a group with a total sample size 19 women of productive age (18-40 years) diagnosed with PCOS. The pre and post combination therapy was observed for ten weeks. Metformin 500 mg three times daily for ten weeks and clomiphene citrate 100 mg in 3rd day until 7th day of menstruation for two cycles were given to the subjects. The result showed that HOMA-IR value decrease after 10 weeks in which value before therapy was 4.9 ± 2.4 and after therapy 3.7 ± 2.2 with the achievement 21.1% HOMA-IR under 2.5. Estradiol concentration after therapy also decreased from 64.8 ± 24.7 pg/ml to 37.9 ± 17.9 pg/ml in ten weeks this concentration remained the range of the follicular phase estradiol levels. On the other hand, follicle size increased from 4.7 ± 0.6 mm to 10.7 ± 2.2 mm after combination therapy of metformin and clomiphene citrate with the occurrence of ovulation 31.6% but none of the samples were successfully pregnant. It is concluded that women with PCOS, declined HOMA-IR, estradiol, and increased follicle size was associated with a good response to combination therapy of metformin and clomiphene citrate.


polycystic ovary syndrome, metformin, clomiphene citrate, HOMA-IR, follicle size, estradiol, PCOS

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