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The use of metformin for women with PCOS undergoing IVF treatment.
Hum Reprod. 2006 Jun; 21(6):1416-25.HR

Abstract

BACKGROUND

Metformin appears to improve reproductive function in some women with polycystic ovary syndrome (PCOS). We wished to explore the effect of metformin in women with PCOS undergoing IVF.

METHODS

A randomized, placebo-controlled, double-blind study was carried out between 2001 and 2004. Patients with PCOS undergoing IVF/ICSI treatment using a long GnRH agonist protocol were randomized to receive metformin (MET), 850 mg, or placebo (PLA) tablets twice daily from the start of the down-regulation process until the day of oocyte collection. The primary outcome was to be an improvement in the overall fertilization rate.

RESULTS

One-hundred and one IVF/ICSI cycles were randomized to receive metformin (52) or to receive placebo (49). There was no difference in the total dose of rFSH required per cycle (median dose: MET = 1200 U, PLA = 1300 U; P = 0.937). The median number of oocytes retrieved per cycle (MET = 17.2, PLA = 16.2; P = 0.459) and the overall fertilization rates (MET = 52.9%, PLA = 54.9%; P = 0.641) did not differ. However, both the clinical pregnancy rates beyond 12 weeks gestation per cycle (MET = 38.5%, PLA = 16.3%; P = 0.023) and per embryo transfer (MET = 44.4%, PLA = 19.1%; P = 0.022) were significantly higher in those treated with metformin. Furthermore, a significant decrease in the incidence of severe ovarian hyperstimulation syndrome (OHSS) was observed (MET = 3.8%, PLA = 20.4%; P = 0.023), and this was still significant after adjustment for BMI, total rFSH dose and age (OR = 0.15; 95% CI: 0.03, 0.76; P = 0.022).

CONCLUSION

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.

Authors+Show Affiliations

Department of Reproductive Medicine, The General Infirmary, Leeds, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16501038

Citation

Tang, Thomas, et al. "The Use of Metformin for Women With PCOS Undergoing IVF Treatment." Human Reproduction (Oxford, England), vol. 21, no. 6, 2006, pp. 1416-25.
Tang T, Glanville J, Orsi N, et al. The use of metformin for women with PCOS undergoing IVF treatment. Hum Reprod. 2006;21(6):1416-25.
Tang, T., Glanville, J., Orsi, N., Barth, J. H., & Balen, A. H. (2006). The use of metformin for women with PCOS undergoing IVF treatment. Human Reproduction (Oxford, England), 21(6), 1416-25.
Tang T, et al. The Use of Metformin for Women With PCOS Undergoing IVF Treatment. Hum Reprod. 2006;21(6):1416-25. PubMed PMID: 16501038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of metformin for women with PCOS undergoing IVF treatment. AU - Tang,Thomas, AU - Glanville,Julie, AU - Orsi,Nic, AU - Barth,Julian H, AU - Balen,Adam H, Y1 - 2006/02/24/ PY - 2006/2/28/pubmed PY - 2006/11/11/medline PY - 2006/2/28/entrez SP - 1416 EP - 25 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 21 IS - 6 N2 - BACKGROUND: Metformin appears to improve reproductive function in some women with polycystic ovary syndrome (PCOS). We wished to explore the effect of metformin in women with PCOS undergoing IVF. METHODS: A randomized, placebo-controlled, double-blind study was carried out between 2001 and 2004. Patients with PCOS undergoing IVF/ICSI treatment using a long GnRH agonist protocol were randomized to receive metformin (MET), 850 mg, or placebo (PLA) tablets twice daily from the start of the down-regulation process until the day of oocyte collection. The primary outcome was to be an improvement in the overall fertilization rate. RESULTS: One-hundred and one IVF/ICSI cycles were randomized to receive metformin (52) or to receive placebo (49). There was no difference in the total dose of rFSH required per cycle (median dose: MET = 1200 U, PLA = 1300 U; P = 0.937). The median number of oocytes retrieved per cycle (MET = 17.2, PLA = 16.2; P = 0.459) and the overall fertilization rates (MET = 52.9%, PLA = 54.9%; P = 0.641) did not differ. However, both the clinical pregnancy rates beyond 12 weeks gestation per cycle (MET = 38.5%, PLA = 16.3%; P = 0.023) and per embryo transfer (MET = 44.4%, PLA = 19.1%; P = 0.022) were significantly higher in those treated with metformin. Furthermore, a significant decrease in the incidence of severe ovarian hyperstimulation syndrome (OHSS) was observed (MET = 3.8%, PLA = 20.4%; P = 0.023), and this was still significant after adjustment for BMI, total rFSH dose and age (OR = 0.15; 95% CI: 0.03, 0.76; P = 0.022). CONCLUSION: 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. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/16501038/The_use_of_metformin_for_women_with_PCOS_undergoing_IVF_treatment_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/del025 DB - PRIME DP - Unbound Medicine ER -