Research supports use of metformin with PCOS and IVF

Polycystic ovary syndrome (PCOS) has become more widely known in recent years as a fairly common hormonal disorder and as a leading cause of infertility. Many doctors prescribe metformin – a drug primarily used to treat type 2 diabetes – to balance the hormones in patients with PCOS. In medical terms, metformin reduces hyperinsulinemia and suppresses the excessive ovarian production of androgens (male hormones) in women with PCOS.

In the past, researchers have recommended the use of metformin in patients whose goal was getting pregnant with PCOS through IVF, as it is supposed to improve success rates and reduce the incidence of ovarian hyperstimulation syndrome (OHSS).

Recent research supports the use of metformin when the patient has PCOS and IVF is being pursued. Dr. L. O. Tso and colleagues from Sao Paulo Brazil recently reviewed the literature and combined the results (meta-analysis) from nine randomized controlled trials including 816 women. They found that:

• When metformin was compared with a placebo, no statistical significant difference was found between the groups in live birth rates. If the chance of a live birth without the use of metformin is assumed to be 32%, the corresponding chance with the use of metformin is assumed to be between 28% and 53% (95%CI).
• However, when clinical pregnancy rates were compared, they were significantly higher with the use of metformin. If the chance of a clinical pregnancy without the use of metformin is assumed to be 31%, the corresponding chance with the use of metformin is assumed to be between 32% and 49% (95%CI).
• When metformin was compared with placebo or no treatment, the risk of OHSS was significantly lower in the metformin group. If the risk of OHSS without the use of metformin is assumed to be 27%, the corresponding risk with use of metformin is estimated to be between 6% and 15% (95% CI).
• The metformin group, however had a higher incidence of gastrointestinal side effects.

Based on these results, it would make sense to use metformin liberally in PCOS patients undergoing IVF.

To see a fertility specialist with decades of experience combining treatment for PCOS and the IVF process, make an appointment at one of InVia’s four Chicago area fertility clinics.