Update on the therapeutic role of metformin in the management of polycystic ovary syndrome: Effects on pathophysiologic process and fertility outcomes.

Ovulation Metformin versus no metformin or clomifene citrate The meta-analysis embedded within the 2023 guidelines for PCOS management reported a strong trend towards increased ovulation rate with metformin versus placebo, with no difference for metformin versus clomifene citrate ( Figure 3 ). 21 Metformin plus clomifene citrate was more effective than clomifene citrate alone, but not metformin alone in this analysis ( Figure 3 ).

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