The use of metformin for women with PCOS undergoing IVF treatment

Tang, Thomas; Glanville, Julie; Orsi, Nicolas M.; Barth, Julian H.; Balen, Adam

doi:10.1093/humrep/del025

Cited by 190 publications

(160 citation statements)

References 64 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…Some authors have suggested that the concomitant use of metformin while patients are being stimulated for IVF not only might increase the pregnancy rates but also could decrease the incidence of OHSS. 38 Conversely, a recent meta-analysis by Costello et al 39 did not demonstrate any benefits from the cotreatment with metformin.…”

Section: Anovulationmentioning

confidence: 95%

Advances and Controversies in Assisted Reproductive Technology

Vela

Luna

Sandler

et al. 2009

Mount Sinai J Medicine

View full text Add to dashboard Cite

As the incidence and awareness of infertility have increased in the last decades, reproductive endocrinologists and scientists have striven to improve the therapeutic options being offered to patients. One of the most advanced and efficient technologies currently being offered is assisted reproductive technology. Among the various techniques that are comprised by assisted reproductive technology, in vitro fertilization is the most widely studied and used, being responsible for approximately 1% of all live births in the United States. As this technology has evolved, many controversies have arisen, and it is the purpose of this article to review what in the authors' opinion are the most current and controversial aspects of the whole process of in vitro fertilization and its related techniques. Mt Sinai J Med 76:506‐520, 2009. © 2009 Mount Sinai School of Medicine

show abstract

Section: Anovulationmentioning

confidence: 95%

Advances and Controversies in Assisted Reproductive Technology

Vela

Luna

Sandler

et al. 2009

Mount Sinai J Medicine

View full text Add to dashboard Cite

show abstract

“…Metformin is a biguanide who mainly acts by reducing hepatic glucose production, but also improves insulin sensitivity to some extent. This drug also reduces appetite in many PCOS women and is thus often [133], but not always [134], associated with more weight loss. Metformin has been shown to be effective in all women with PCOS, even those without insulin resistance and hyperinsulinemia [47, [135][136][137], but tends to be more effective in lean as compared to obese PCOS women [138].…”

Section: Insulin-sensitizing Drugsmentioning

confidence: 99%

Insulin and hyperandrogenism in women with polycystic ovary syndrome

Baptiste

Battista

Trottier

et al. 2010

The Journal of Steroid Biochemistry and Molecular Biology

260

199

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) is a very common endocrine disorder characterized by chronic anovulation, clinical and/or biochemical hyperandrogenism, and/or polycystic ovaries. But most experts consider that hyperandrogenism is the main characteristic of PCOS. Several theories propose different mechanisms to explain PCOS manifestations: (1) a primary enzymatic default in the ovarian and/or adrenal steroidogenesis; (2) an impairment in gonadotropin releasing hormone (GnRH) secretion that promotes luteal hormone (LH) secretion; or (3) alterations in insulin actions that lead to insulin resistance with compensatory hyperinsulinemia. However, in the past 20 years there has been growing evidence supporting that defects in insulin actions or in the insulin signalling pathways are central in the pathogenesis of the syndrome. Indeed, most women with PCOS are metabolically insulin resistant, in part due to genetic predisposition and in part secondary to obesity. But some women with typical PCOS do not display insulin resistance, which supports the hypothesis of a genetic predisposition specific to PCOS that would be revealed by the development of insulin resistance and compensatory hyperinsulinemia in most, but not all, women with PCOS. However, these hypotheses are not yet appropriately confirmed, and more research is still needed to unravel the true pathogenesis underlying this syndrome. The present review thus aims at discussing new concepts and findings regarding insulin actions in PCOS women and how it is related to hyperandrogenemia.

show abstract

“…The Norwegian group 32 observed that the lean sub-group showed a statistically increased pregnancy rate, and the study by Tang et al, 33 which included relatively lean patients in the whole study group, showed an unambiguous improvement in pregnancy rate. A large multi-centre study is now addressing this issue and we await the outcome with some anticipation It would appear that the mechanism for any beneficial effect is unrelated to changes in FSH sensitivity and gross ovarian responses, as these were not influenced by metformin treatment in either study.…”

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

confidence: 96%

“…The main observations in two randomised control studies 32,33 indicate that relatively short-term metformin treatment does not influence total follicular responses to exogenous FSH, evidenced by numbers of follicles, duration and dose of FSH and numbers of oocytes. This is an important observation, leading us to conclude that short-term modulation of the insulin and androgen environment does not affect either the stockpile of follicles awaiting FSH stimulation or the sensitivity of those individual follicles to FSH stimulation in terms of growth rate and amount of FSH required to achieve maturation.…”

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

The use of metformin for women with PCOS undergoing IVF treatment

Abstract: 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.

Cited by 190 publications

References 64 publications

Advances and Controversies in Assisted Reproductive Technology

Advances and Controversies in Assisted Reproductive Technology

Insulin and hyperandrogenism in women with polycystic ovary syndrome

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

Contact Info

Product

Resources

About