Hum. Reprod. Advance Access published online on February 24, 2006
Human Reproduction, doi:10.1093/humrep/del025
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Department of Reproductive Medicine, UK
* To whom correspondence should be addressed. 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.
Received October 25, 2005
Revised January 11, 2006
Accepted January 13, 2006
Article
The use of metformin for women with PCOS undergoing IVF treatment
Thomas Tang 1,
Julie Glanville 1,
Nic Orsi 2,
Julian H.Barth 3,
and
Adam H.Balen 4 *
2 Department of Clinical Biochemistry, UK
3 Perinatal Research Group, Academic Unit of Paediatrics, Obstetrics and Gynaecology, The General Infirmary, Leeds, UK
4 Department of Reproductive Medicine, Clarendon Wing, The General Infirmary,
Leeds, UK
Adam H.Balen, E-mail: adam.balen{at}leedsth.nhs.uk
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  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]
|
|