Role of Chromium Versus Metformin Supplementations as Adjuvant for Ovulation Induction By Clomiphene Citrate in Infertile Patients With Polycystic Ovary Syndrome : Randomized Controlled Trial

Aim: This study aimed to explore the effect of chromium picolinate compared to Metformin supplementation with ovulation induction in polycystic ovary syndrome, In particular, its effect on insulin sensitivity, ovarian response and pregnancy rate. Materials and Methods: This study was conducted as a prospective study, aimed to compare the effect of Chromium and Metformin supplementations on ovulation rate in Polycystic ovary patients undergoing ovulation induction. The present study included 140 women divided into 2 groups each is 70 infertile women diagnosed as polycystic ovary syndrome according to Rotterdam criteria 2017: (oligo-ovulation or anovulation, clinical or biochemical signs of hyperandrogenism, polycystic ovaries on ultrasound). Results: Fasting blood sugar (FBS) and fasting insulin level were significantly decreased in metformin group than in Chromium picolinate group after 3 months of treatment ( p=0.006 ) ( p=0.026 ) respectively. Testosterone significantly decreased in both groups at follow up as compared to basal level ( P-value <0.001, <0.001 respectively with no significant difference between the studied groups regarding testosterone reduction ( P-value=0.416 ) after 3 months of treatment. The two study groups were not significantly different regarding ovulation and pregnancy rates( P-value 0.157, 0.550 ) respectively after 3 months of treatment. The patients who received metformin experienced more side effects compared to those receiving chromium picolinate ( p=0.001 ). Conclusion: I n view of the aforementioned findings, we recommend that metformin could be replaced by chromium picolinate in some PCOS patients, as its better tolerated than metformin due to lower side effects and no significant differences were observed between the two groups regarding ovulation and pregnancy rates.