Metformin with Clomid :: NEJM Abstract

[Warrior]

I was searching the journals for something else regarding Clomid and stumbeled on this abstract:

Effects of Metformin on Spontaneous and Clomiphene-Induced Ovulation in the Polycystic Ovary Syndrome

John E. Nestler, M.D., Daniela J. Jakubowicz, M.D., William S. Evans, M.D., and Renato Pasquali, M.D.

ABSTRACT

Background Obese women with the polycystic ovary syndrome are relatively unresponsive to the induction of ovulation by clomiphene. We hypothesized that reducing insulin secretion by administering metformin would increase the ovulatory response to clomiphene.

Methods We performed oral glucose-tolerance tests before and after the administration of 500 mg of metformin or placebo three times daily for 35 days in 61 obese women with the polycystic ovary syndrome. Women who did not ovulate spontaneously were then given 50 mg of clomiphene daily for five days while continuing to take metformin or placebo. Serum progesterone was measured on days 14, 28, 35, 44, and 53, and ovulation was presumed to have occurred if the concentration exceeded 8 ng per milliliter (26 nmol per liter) on any of these days.

Results

Twenty-one women in the metformin group and 25 women in the placebo group were given clomiphene because they did not ovulate spontaneously during the first phase of the study. Among the 21 women given metformin plus clomiphene, the mean (±SE) area under the serum insulin curve after oral glucose administration decreased from 6745±2021 to 3479±455 µU per milliliter per minute (40.5±12.1 to 20.9±2.7 nmol per liter per minute, P=0.03), but it did not change significantly in the 25 women given placebo plus clomiphene. Nineteen of the 21 women (90 percent) who received metformin plus clomiphene ovulated (mean peak serum progesterone concentration, 23.8±3.4 ng per milliliter [7.6±10.9 nmol per liter]). Two of the 25 women (8 percent) who received placebo plus clomiphene ovulated (P<0.001). Overall, 31 of the 35 women (89 percent) treated with metformin ovulated spontaneously or in response to clomiphene, as compared with 3 of the 26 women (12 percent) treated with placebo.

Conclusions

The ovulatory response to clomiphene can be increased in obese women with the polycystic ovary syndrome by decreasing insulin secretion with metformin.

Source Information

From the Departments of Medicine at the Medical College of Virginia, Virginia Commonwealth University, Richmond (J.E.N.); Hospital de Clinicas Caracas, Caracas, Venezuela (D.J.J.); the University of Virginia, Charlottesville (W.S.E.); and the University of Bologna, Bologna, Italy (R.P.).

Address reprint requests to Dr. Nestler at the Medical College of Virginia, P.O. Box 980111, Richmond, VA 23298-0111.

Hang on! I know what you are saying - "we aren't obese women with Polycystic Ovary Syndrome!" but think of it this way: These woman were obese with insulin resistance. So the study is showing that increasing insulin sensitivity, like after a cycle (which could be lowered to a degree depending on what the cycle) with Metformin (Glucophage) or possible Avandia-type drugs may help men better use Clomid to recover faster from AAS use... by increasing its efectiveness.

[Warrior]

Well, I am 6 weeks post cycle and haven't lost anything (actually been progressing well using a journal) - was up to 270 and currently holding 268... and I have been doing a lot of cardio the last several weeks.

I attacked PCT this time using this information (above)... following some HCG use while waiting for the androgens to pass.

I used the Clomid with Avandia (similar to Metformin) using the clinical recommendations... well at least similar to them. Using 6-7 day rotations of Clomid to recover... like what they used in the studies for Clomid to successfully stimulate ovulation in women (obviously a sign it is working)...

Used 3 boxes of Clomid 50mg with some Avandia 4mg...

First Box (Clomid mg/Avandia mg)
100,4/100,4/100,4/50,4/50,4/50,4/50,4

Waited 2 days then...
100,4/100,4/100,4/100,4/50,4/50

Waited 3 days then...
100,4/100,4/100,4/100,4/50,4/50

And quite honestly I belive I am completely recovered (been felling this way after the first box) and don't need to continue Clomid beyond tomorrow's final dose... based on the assumption that my weight has stayed up, strength gains gave been consistent and overall disposition is good.

Anyone feel like experimenting PCT? Give this a try...