Use of metformin before and during assisted reproductive technology in non-obese young infertile women with polycystic ovary syndrome: a prospective, randomized, double-blind, multi-centre study

Abstract

ClinicalTrials.gov Identifier: NCT00159575.

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

“…Among IVF-treated women, there was no difference in clinic pregnancy rate between metformin and placebo groups. However, due to spontaneous pregnancies that occurred prior to IVF, there was a significantly higher clinical pregnancy rate (50 % versus 33.3 %, p= 0.04) and live birth rate (48.6 % versus 32.0 %, p=0.04) in the metformin group [13]. Interestingly, in a previous doubleblind randomized control trial performed by the same group in which PCOS patients were stratified by weight, there were no differences between pregnancy and live birth rates in the metformin versus placebo groups among all patients.…”

“…The two most common endpoints are a positive pregnancy test (35 %) and at 12 weeks gestational age (33 %). This trend in the variability of pretreatment (if any) and treatment duration seems to be mirrored by various major studies as well-ranging from≥16 weeks to the beginning of ovulation induction for the starting time of metformin, and from hCG administration to the 12th week of pregnancy for the stopping time [10][11][12][13][14][15][16][17][18][19]. However, analysis shows no significant effect on pregnancy and live birth rates among PCOS patients after these studies were categorized by long term pretreatment (>3 weeks), short term pretreatment (≤3 weeks), or no pretreatment, and by stopping time of metformin with hCG administration, oocyte retrieval and embryo transfer as endpoints [21].…”

“…There was also a significant decrease in ovarian hyperstimulation syndrome (OHSS), with 3.8 % in the metformin group versus 20.4 % with placebo (p=0.02) [16]. A double-blind randomized controlled trial by Kjotrod et al (2011) explored the effect of metformin in 150 non-obese women with PCOS (BMI<28 kg/m 2 ) undergoing IVF therapy. Subjects were treated with metformin for 12 weeks or more prior to the cycle start.…”

“…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.…”

Application of dietetics in reproductive medicine

“…Live births were noted in 48.6% of the women who received metformin, while among those who received placebo -32%. The researchers emphasized that the clinical outcome resulted from increasing the chance for spontaneous pregnancy in the group receiving metformin, and was not the effect of the improvement of the effectiveness of IVF [17]. It was also confirmed that the reduction of body weight in women with PCOS, leading to reduction in insulin resistance, increased the chance for regaining spontaneous ovulatory function or improvement of the response to the stimulation of the ovaries [18].…”