title: Pregnancies following use of metformin for ovulation induction in patients with polycystic ovary syndrome.
abstract: OBJECTIVE
  To assess pregnancy outcome in anovulatory infertility patients diagnosed with polycystic ovary syndrome (PCOS) who were treated with metformin.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Outpatient.
  
  
  METHODS
  Anovulatory patients (n = 48) with a diagnosis of PCOS based on clinical, diagnostic, and laboratory evaluations were enrolled in the study over a 15-month period.
  
  
  METHODS
  Metformin was started at 500 mg b.i.d. for 6 weeks and then increased to 500 mg t.i.d. if no ovulation occurred. Clomiphene citrate (CC; 50 mg) was added if no ovulatory response occurred after 6 weeks.
  
  
  METHODS
  Resumption of menses, presumptive ovulation, and pregnancy.
  
  
  RESULTS
  Nineteen of 48 (40%) patients resumed spontaneous menses following treatment and showed presumptive evidence of ovulation with metformin alone; 15/48 (31%) required CC (50 mg) in conjunction with metformin therapy, and 10 of these 15 (67%) had evidence of ovulation; 20/48 (42%) conceived with a median time to conception of 3 months, and 7 of these 20 (35%) had spontaneous abortions (SAB); 19/48 (40%) had gastrointestinal-related side effects, and 5 of 48 patients (10%) had to decrease the dosage of metformin. Only 1 patient discontinued therapy.
  
  
  CONCLUSIONS
  Metformin alone in patients with PCOS results in a substantial number of pregnancies, with 69% (20/29) of those who ovulated conceiving in less than 6 months.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Heard
authors.forename: Anita
authors.initials: A
authors.lastname: Pierce
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Carson
authors.forename: John E
authors.initials: JE
authors.lastname: Buster
mesh_terms: D000328:Adult; D000858:Anovulation / Q000188:drug therapy / Q000209:etiology; D002996:Clomiphene / Q000008:administration & dosage; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D008687:Metformin