Do women with ovaries of polycystic morphology without any other features of PCOS benefit from short-term metformin co-treatment during IVF? A double-blind, placebo-controlled, randomized trial

Abstract

There appears to be no benefit in metformin co-treatment before and during IVF in women with PCO without any other features of PCOS. Clinical Trials.gov: NCT01046032.

The clinical ramifications of polycystic ovarian morphology in oocyte donors

“…Our study also showed significantly higher serum E2 concentrations and more follicles in the PCO morphology group compared to controls. These findings are again consistent to what has been demonstrated in the literature in both PCOS and PCO morphology patients [12,20,24]. We also observed that women with PCO morphology had on average 2 more oocytes retrieved than controls, but this difference did not reach statistical significance.…”

“…However, some elements of the response to ovarian stimulation in our study are different from what has been shown in the past for patients with PCOS or PCO morphology. Increased sensitivity to gonadotropins has been demonstrated in the literature in patients with PCOS [20] and also with PCO morphology in an older study [24], likely due to a larger cohort of FSH sensitive follicles [23]. Our study also agrees with the above literature showing that donors with PCO morphology are more responsive to gonadotropins.…”

“…Women with PCOS have been reported to produce lower quality oocytes with lower fertilization rates than controls [1,8]. However, these findings have not been replicated in women with PCO morphology [12,20,24]. Consistent with earlier reports, we did not see any differences in number of mature oocytes, fertilization rates, day 3 embryos and progression to blastocyst in PCO morphology and control groups.…”

“…While studies have demonstrated a decreased rate of OHSS with metformin administration for PCOS patients undergoing IVF [22], a randomized placebo controlled study did not show decreased rates of severe OHSS for patients with polycystic ovarian morphology [20]. Still, other techniques used to control for OHSS in PCOS patients such as agonist trigger have been shown to be successful in decreasing OHSS risks PCO patients [11].…”

Endocrinological insights into differentin vitrofertilization treatment aspects

“…However, studies have shown that for PCOS patients undergoing IVF treatment, short-term cotreatment with metformin neither enhances the response to the stimulation nor improves the fertilization rate, but does improve the pregnancy outcome [82]. In addition, more recent studies and reviews have shown that cotreatment with metformin before or during IVF cycles does not improve live birth rates, pregnancy rates or severe OHSS [79,83] …”