Metformin reduces serum mullerian-inhibiting substance levels in women with polycystic ovary syndrome after protracted treatment.
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.
Fleming
Richard
R
University Department of Obstetrics and Gynaecology, Royal Infirmary, Glasgow, United Kingdom. gqta13@udcf.gla.ac.uk
Harborne
Lyndal
L
MacLaughlin
David T
DT
Ling
Daniel
D
Norman
Jane
J
Sattar
Naveed
N
Seifer
David B
DB
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*
D006023:Glycoproteins; D007004:Hypoglycemic Agents; D013735:Testicular Hormones; D000735:Androstenedione; D054304:Anti-Mullerian Hormone; D008687:Metformin