Hum. Reprod. Advance Access originally published online on February 24, 2006
Human Reproduction 2006 21(6):1416-1425; doi:10.1093/humrep/del025
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The use of metformin for women with PCOS undergoing IVF treatment
1 Department of Reproductive Medicine, 2 Department of Clinical Biochemistry and 3 Perinatal Research Group, Academic Unit of Paediatrics, Obstetrics and Gynaecology, The General Infirmary, Leeds, UK
4 To whom correspondence should be addressed at: Department of Reproductive Medicine, Clarendon Wing, The General Infirmary, Leeds, LS2 9NS, UK. E-mail: adam.balen{at}leedsth.nhs.uk
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.
Key words: IVF/metformin/OHSS/polycystic ovary syndrome/pregnancy
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. G. BROMER, M. B. CETINKAYA, and A. ARICI Pretreatments before the Induction of Ovulation in Assisted Reproduction Technologies: Evidence-based Medicine in 2007 Ann. N.Y. Acad. Sci., April 1, 2008; 1127(1): 31 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consens Consensus on infertility treatment related to polycystic ovary syndrome Hum. Reprod., March 1, 2008; 23(3): 462 - 477. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Moll, F. van der Veen, and M. van Wely The role of metformin in polycystic ovary syndrome: a systematic review Hum. Reprod. Update, November 1, 2007; 13(6): 527 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Eng, R. A. Sheridan, A. Wyman, M. M.-Y. Chi, K. P. Bibee, E. S. Jungheim, and K. H. Moley AMP Kinase Activation Increases Glucose Uptake, Decreases Apoptosis, and Improves Pregnancy Outcome in Embryos Exposed to High IGF-I Concentrations Diabetes, September 1, 2007; 56(9): 2228 - 2234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Stanek, S. M. Borman, T. A. Molskness, J. M. Larson, R. L. Stouffer, and P. E. Patton Insulin and Insulin-Like Growth Factor Stimulation of Vascular Endothelial Growth Factor Production by Luteinized Granulosa Cells: Comparison between Polycystic Ovarian Syndrome (PCOS) and Non-PCOS Women J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2726 - 2733. [Abstract] [Full Text] [PDF]
|
|