Metformin treatment in patients with polycystic ovary syndrome undergoing in vitro fertilization: a prospective randomized trial

Önalan, Göğşen; Pabuçcu, Recai; Göktolga, Ümit; Ceyhan, Temel; Bağış, Tayfun; Cıncık, Mehmet

doi:10.1016/j.fertnstert.2005.03.043

Cited by 46 publications

(64 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The 3 studies used for the meta-analysis were prospective randomized, placebo-control, double-blind, but only reported side effects with metformin as a secondary outcome. The only adverse event acknowledges was gastrointestinal symptoms [42,43,44]. Lactic acidosis is a rare but a serious side effect with a case fatality rate as high as 50.3% [45].…”

Section: Discussionmentioning

confidence: 99%

Is Metformin Indicated as Primary Ovulation Induction Agent in Women with PCOS? A Systematic Review and Meta-Analysis

Siebert¹,

Viola²,

Steyn³

et al. 2012

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background: A recent meta-analysis has proven that metformin (M) is highly effective for ovulation induction in the clomiphene citrate (CC)-resistant patient. There is uncertainty whether M should be introduced as a primary ovulation induction agent in polycystic ovarian syndrome (PCOS). Methods: We conducted a systematic review and meta-analysis to establish if M is better when given alone or in combination with CC (CC+M) when compared with CC alone. This systematic review studied live birth delivery rate as the primary outcome. Results: We identified 14 prospective trials. Analysis of these results showed a reduction in the live birth rate in the group of patients treated only with M when compared with CC alone (OR = 0.48, 95% CI 0.31–0.73, p = 0.0006). An increase in ovulation (OR = 1.6, 95% CI 1.2–2.1, p = 0.0009) and pregnancy rate (OR = 1.3, 95% CI 1.0–1.6, p = 0.05) with CC+M when compared with CC alone was reported, but no difference was found when live birth rate was analyzed (OR = 1.1, 95% CI 0.8–1.5, p = 0.61). Conclusion: CC alone is superior to M alone regarding live birth rate and ovulation. The combination (CC+M) is superior to CC alone as a primary method for ovulation induction and to achieve pregnancy in PCOS. However, when addressing live birth rate, no statistically significant difference could be demonstrated. Because of the side effects profile and contraindications of M, we believe M should not be indicated as a primary ovulation induction agent in women with PCOS.

show abstract

Section: Discussionmentioning

confidence: 99%

Is Metformin Indicated as Primary Ovulation Induction Agent in Women with PCOS? A Systematic Review and Meta-Analysis

Siebert¹,

Viola²,

Steyn³

et al. 2012

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…This observation is supported by another randomised trial. 35 Hence there is good clinical reason to use the drug in these circumstances, because women with PCOS are at increased risk of OHSS, which can be a serious side effect of IVF treatment. This is such a dramatic observation that it may also be instructive of the underlying ovarian abnormality in PCOS, and the role of insulin metabolism in vascular development of the ovary and follicles.…”

Section: Metformin In Assisted Conception (Ivf/icsi)mentioning

confidence: 99%

The use of insulin sensitising agents in ovulation induction in women with Polycystic Ovary Syndrome

Fleming

2006

View full text Add to dashboard Cite

Insulin resistance is an important upstream driver for reproductive and metabolic abnormalities in women with Polycystic Ovary Syndrome (PCOS). This theoretical background is now supported by substantial evidence for treating women with PCOS with insulin sensitising agents such as metformin or the thiazolidinediones. Although the available data are based upon studies comprised of relatively small numbers of patients, powerful evidence of potential benefit is emerging. Data from controlled studies, which are usually short-term and of limited magnitude, indicate modest effects of insulin sensitizers on ovulation when applied as the only drug. However, potentially important benefits are achieved when such treatment is combined with other methods. These benefits include both increased fertility and decreased risks for ovarian hyperstimulation syndrome (OHSS). Furthermore, there may also be benefits in terms of alleviation of pregnancy complications. The available evidence supports consideration of the use of metformin from the earliest stages of treatment in women with PCOS.

show abstract

“…Studies to date have demonstrated mixed results for metformin administration in PCOS patients undergoing IVF treatment with respect to reproductive outcomes. These studies displayed considerable heterogeneity in terms of patient characteristics, treatment protocols and study settings [8][9][10][11][12][13][14][15][16][17][18][19][20]. Thus, there is a currently a significant degree of uncertainty for the specific role of metformin in IVF therapy.…”

Section: Introductionmentioning

confidence: 99%

Metformin use in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

Christianson

Zhao

et al. 2015

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

Metformin treatment in patients with polycystic ovary syndrome undergoing in vitro fertilization: a prospective randomized trial

Cited by 46 publications

References 23 publications

Is Metformin Indicated as Primary Ovulation Induction Agent in Women with PCOS? A Systematic Review and Meta-Analysis

Is Metformin Indicated as Primary Ovulation Induction Agent in Women with PCOS? A Systematic Review and Meta-Analysis

The use of insulin sensitising agents in ovulation induction in women with Polycystic Ovary Syndrome

Metformin use in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

Contact Info

Product

Resources

About