[Should infertile women with polycystic ovarian syndrome be treated with metformine?].
Polycystic ovary syndrome is a frequent endocrine disorder often associated with insulin resistance and hyperinsulinaemia which may play a role in hyperandrogenism and anovulation. The use of "insulin sensitizing" agents has been suggested to reduce insulin resistance and hyperandrogenism. In that respect, the use of metformin in polycystic ovary syndrome is reviewed. Although its mechanism of action is still unclear, metformin proved to be effective to restore cyclicity and spontaneous ovulation. The synergistic effect of clomiphene citrate and metformin was demonstrated in some studies, suggesting that metformin could be helpful for women with clomiphene citrate resistance. However, the potential effect of metformin administration for reducing hyperstimulation in women treated with exogenous FSH, or for preventing early miscarriages has to be confirmed. Here, we propose a guideline for the use of metformin, as an adjuvant therapy, to restore cyclicity and ovulation in women with polycystic ovary syndrome.
Massin
N
N
Service de médecine de la reproduction, CHU Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France.
Galey
J
J
Basille
C
C
Théron-Gérard
L
L
Bry-Gauillard
H
H
Cédrin-Durnerin
I
I
Hugues
J N
JN
D002996:Clomiphene / Q000627:therapeutic use; D004357:Drug Synergism; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000188:drug therapy; D006946:Hyperinsulinism / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000150:complications / Q000188:drug therapy*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D010060:Ovulation / Q000187:drug effects; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin