The use of metformin for women with PCOS undergoing IVF treatment
Open Access
- 24 February 2006
- journal article
- research article
- Published by Oxford University Press (OUP) in Human Reproduction
- Vol. 21 (6), 1416-1425
- https://doi.org/10.1093/humrep/del025
Abstract
BACKGROUND: Metformin appears to improve reproductive function in some women with polycystic ovary syndrome (PCOS). We wished to explore the effect of metformin in women with PCOS undergoing IVF. METHODS: A randomized, placebo-controlled, double-blind study was carried out between 2001 and 2004. Patients with PCOS undergoing IVF/ICSI treatment using a long GnRH agonist protocol were randomized to receive metformin (MET), 850 mg, or placebo (PLA) tablets twice daily from the start of the down-regulation process until the day of oocyte collection. The primary outcome was to be an improvement in the overall fertilization rate. RESULTS: One-hundred and one IVF/ICSI cycles were randomized to receive metformin (52) or to receive placebo (49). There was no difference in the total dose of rFSH required per cycle (median dose: MET = 1200 U, PLA = 1300 U; P = 0.937). The median number of oocytes retrieved per cycle (MET = 17.2, PLA = 16.2; P = 0.459) and the overall fertilization rates (MET = 52.9%, PLA = 54.9%; P = 0.641) did not differ. However, both the clinical pregnancy rates beyond 12 weeks gestation per cycle (MET = 38.5%, PLA = 16.3%; P = 0.023) and per embryo transfer (MET = 44.4%, PLA = 19.1%; P = 0.022) were significantly higher in those treated with metformin. Furthermore, a significant decrease in the incidence of severe ovarian hyperstimulation syndrome (OHSS) was observed (MET = 3.8%, PLA = 20.4%; P = 0.023), and this was still significant after adjustment for BMI, total rFSH dose and age (OR = 0.15; 95% CI: 0.03, 0.76; P = 0.022). CONCLUSION: Short-term co-treatment with metformin for patients with PCOS undergoing IVF/ICSI cycles does not improve the response to stimulation but significantly improves the pregnancy outcome and reduces the risk of OHSS.Keywords
This publication has 62 references indexed in Scilit:
- Testosterone Measurement by Isotope-Dilution Liquid Chromatography–Tandem Mass Spectrometry: Validation of a Method for Routine Clinical PracticeClinical Chemistry, 2005
- Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome?Human Reproduction Update, 2005
- Metformin reduces serum müllerian-inhibiting substance levels in women with polycystic ovary syndrome after protracted treatmentFertility and Sterility, 2005
- The effect of metformin on ovarian stimulation andin vitrofertilization in insulin-resistant women with polycystic ovary syndrome: an open-label randomized cross-over trialGynecological Endocrinology, 2003
- Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference?Clinical Endocrinology, 2002
- Endocrinology of the peri-implantation periodBest Practice & Research Clinical Obstetrics & Gynaecology, 2000
- The pathogenesis of ovarian hyperstimulation syndrome: in vivo studies investigating the role of interleukin-1β, interleukin-6, and vascular endothelial growth factorFertility and Sterility, 1999
- Serum Androgen Levels in Women who Have Recurrent Miscarriages and their Correlation with Markers of Endometrial FunctionFertility and Sterility, 1998
- Free testosterone and abortion in early pregnancyInternational Journal of Gynecology & Obstetrics, 1993