Abstract
OBJECTIVE: To investigate the effects of Diane-35 combined with metformin on hormone levels and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS). METHODS: A retrospective analysis was conducted on patients diagnosed with PCOS who received treatment at our hospital between January 2023 and October 2024. Patients were divided into control and study groups based on their treatment regimens. The control group received conventional metformin therapy, while the study group received Diane-35 in addition to metformin. The inclusion criteria are based on the 2003 Rotterdam Conference criteria (oligoovulation/anovulation, hyperandrogenism, polycystic ovary morphology); Exclusion criteria include liver and kidney dysfunction, pituitary adrenal/thyroid disease, non PCOS infertility factors, fallopian tube obstruction, immune/hematological abnormalities, and severe complications. Finally, 170 PCOS patients were included (85 in each group after propensity score matching, Using propensity score matching (PSM) for 1:1 non replacement matching, based on age BMI, Construct a logistic regression model to calculate propensity score for 9 baseline characteristics, including basal hormone levels, with a caliper value of 0.02. After matching, the standardized deviations of each variable were all <10% and there was no significant difference in t-test). Hormone levels were compared between the two groups, and pregnancy outcomes were analyzed for patients with successful pregnancies. RESULTS: After treatment, the study group demonstrated significant reductions in ovarian volume and antral follicle count, alongside increased endometrial thickness (P < 0.05). Body mass index (BMI), luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T) levels, and insulin resistance index (HOMA-IR) were lower in the study group compared to the control group (P < 0.05), while estradiol (E2) levels were significantly elevated (P < 0.05). The study group achieved a higher pregnancy success rate (89.41% vs 34.12%) and live birth rate (98.68% vs 79.31%) compared to the control group (P < 0.05), with a markedly lower abortion rate (5.88% vs 25.88%) (P < 0.05). CONCLUSION: This study confirms the significant efficacy of Diane-35 combined with metformin in improving hormone levels and pregnancy outcomes in PCOS patients, but it should be noted that retrospective design may have selection bias, short-term observation (12 months) limits long-term safety evaluation, and insufficient sample size limits subgroup analysis (such as differences in efficacy among different BMI stratification). Future multicenter prospective studies are needed for validation.