The Effect of Metformin on the Endometrium of Women with Polycystic Ovary Syndrome

Abstract

Objectives: To investigate the effect of metformin on endometrial receptivity in women with polycystic ovary syndrome (PCOS). Methods: Twenty volunteer women with polycystic ovaries and oligomenorrhea were prospectively investigated. All women were treated with exogenous estradiol and progesterone to simulate a normal menstrual cycle (28-day duration) after GnRH-induced pituitary desensitization. Ten of the women received no other medication (group A, control), while the remaining 10 received metformin (group B, metformin). Endometrial biopsy was performed in all women on day 21 of the 2 simulated cycles. Results: The expression of corticotropin – releasing hormone and urocortin in the endometrium was investigated. There was no significant difference between the 2 groups. A 3-day delay in the secretory maturation of the glandular epithelium relatively to the stroma was observed in 7 out of 10 women of group B (70%) as compared to only 1 out of 10 women of group A (10%, p = 0.02). Conclusions: It is shown for the first time that metformin administration to women with PCOS did not affect the expression of endometrial receptivity markers but delayed histological glandular maturation. It is suggested that metformin may have an impact on the function of the endometrium in PCOS.

Flutamide ameliorates uterine decidualization and angiogenesis in the mouse hyperandrogenemia model during mid-pregnancy

“…Numerous studies have illustrated that infertile PCOS patients present the impairment of endometrial receptivity and were vulnerable to undergo recurrent pregnancy loss, premature labour and fetal growth retardation [2, 6]. However, exact mechanism involving it still needed further investigation.…”

“…However, continued adenoviral delivery of cyclin D3 to support normal decidualization in defect endometrium was flawed, because repeated administration can result in animal sickness and even lethal to pups before delivery [24]. Other common pharmacological options for hyperandrogenemia present in PCOS patients are involved in dexamethasone, metformin and flutamide [2]. Through incubating endometrial cells of normal cycling women, dexamethasone was verified to restore the impairment of a low-dose testosterone on endometrium, but had no effect on high dose.…”

The Effect of Sildenafil Citrate on Poor Endometrium in Patients Undergoing Frozen-Thawed Embryo Transfer following Resection of Intrauterine Adhesions: A Retrospective Study

“…The 3 prerequisite factors for successful implantation are the em- bryo with implantation competency, the endometrium in receptive state, and the synchronized development of both the embryo and the endometrium [13]. It is generally accepted that endometrial receptivity is critical to successful pregnancy [14], it is a multifactorial process [15], and secondary infertility is a common initial symptom of IUAs [2]. The present study has revealed that vaginal administration of sildenafil citrate during FET in patients receiving resection of IUAs evidently improves their pregnancy outcomes, which can be viewed as a promising treatment for infertile women with endometrial insufficiency after FET.…”

Serum Copper Level and Polycystic Ovarian Syndrome: A Meta-Analysis

“…PCOS is a common endocrine and reproductive syndrome that is frequently associated with obesity, insulin resistance, metabolic disorders, and cardiovascular risk factors [25][26][27][28]. The etiology of this syndrome remains largely unclear, but increasing evidence suggests that PCOS might be that of a complex multigenic trait in which environmental influences play an important role, such as organic compounds and heavy metals [29,30].…”