title: Metformin reduces serum mullerian-inhibiting substance levels in women with polycystic ovary syndrome after protracted treatment.
abstract: OBJECTIVE
  Assessment of ovarian responses to metformin treatment in obese women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Prospective treatment with randomization to two doses of metformin.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Obese women (n = 82) with PCOS.
  
  
  METHODS
  Markers of ovarian function were assessed after 4 and 8 months.
  
  
  METHODS
  Hormone (androgens and mullerian-inhibiting substance [MIS]) changes over time.
  
  
  RESULTS
  There was no difference in the reproductive hormone changes between the doses of metformin, and data were combined for further analyses. Significant responses to treatment were recorded for menstrual frequency and androstenedione (A) (reduction) within the first 4 months of treatment. However, suppression of the elevated circulating MIS concentrations required protracted treatment, because no change was observed in the first 4 months-only in the second 4-month assessment period.
  
  
  CONCLUSIONS
  Metformin treatment of PCOS leads to rapid suppression of A and improved menstrual frequency. Suppression of MIS is a delayed response that may be secondary to the development of a cohort of follicles that underwent initial recruitment in an environment of reduced insulin stimulation.
authors.affiliation: University Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow, United Kingdom. gqta13@udcf.gla.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Fleming
authors.forename: Lyndal
authors.initials: L
authors.lastname: Harborne
authors.forename: David T
authors.initials: DT
authors.lastname: MacLaughlin
authors.forename: Daniel
authors.initials: D
authors.lastname: Ling
authors.forename: Jane
authors.initials: J
authors.lastname: Norman
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: David B
authors.initials: DB
authors.lastname: Seifer
mesh_terms: D000328:Adult; D000735:Androstenedione / Q000097:blood; D054304:Anti-Mullerian Hormone; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D010053:Ovary / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D013735:Testicular Hormones / Q000097:blood*
chemical_list: D006023:Glycoproteins; D007004:Hypoglycemic Agents; D013735:Testicular Hormones; D000735:Androstenedione; D054304:Anti-Mullerian Hormone; D008687:Metformin