Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome.
Treatment with insulin-sensitizing agents is a relatively recent therapeutic strategy in women with polycystic ovary syndrome (PCOS) and insulin resistance. The key areas addressed in this review include PCOS and the development of type 2 diabetes mellitus and gestational diabetes, as well as the use of insulin-sensitizing agents, particularly metformin, in the management of infertility in obese and non-obese PCOS women. Treatment with metformin in PCOS women undergoing IVF and the use of metformin during gestation will be discussed. The challenge for the health care professional should be the appropriate utilization of pharmacotherapies to improve insulin sensitivity and lower circulating insulin levels resulting in beneficial changes in PCOS phenotype. Further research into the potential role of other insulin-sensitizing agents, such as pioglitazone and rosiglitazone, in the treatment of infertile women with PCOS is needed.
Checa
M A
MA
Department of Obstetrics and Gynecology, Hospital Universitari del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain. macheca@imas.imim.es
Requena
A
A
Salvador
C
C
Tur
R
R
Callejo
J
J
Espinós
J J
JJ
Fábregues
F
F
Herrero
J
J
D016640:Diabetes, Gestational / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007333:Insulin Resistance; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000453:epidemiology; D011247:Pregnancy
D007004:Hypoglycemic Agents