title: Spontaneous singleton and twin pregnancy in two patients with polycystic ovary syndrome and type 2 diabetes following treatment with metformin combined with rosiglitazone.
abstract: Two women, a Saudi Arab and a Caucasian, aged 28 and 41 years, had a long history of polycystic ovary syndrome (PCOS) and primary infertility, which was refractory to various treatment modalities. Both later developed type 2 diabetes, managed initially with metformin; rosiglitazone was added later to improve glycaemic control. Both conceived spontaneously, resulting in singleton and twin pregnancies giving birth to healthy babies. The combination of rosiglitazone with metformin may result in improved fertility with ovulation and spontaneous conception in women with PCOS and type 2 diabetes. Randomized controlled trials are needed to assess the feasibility of this combination to improve fertility in women with PCOS. However, in the absence of any safety data, those women, following counselling, should be warned against the possibility of spontaneous pregnancy and contraceptive measures should be discussed and offered where appropriate.
authors.affiliation: Department of Endocrinology, Dudley Group of Hospitals NHS Trust, Dudley, West Midlands, UK.
authors.forename: Yared N
authors.initials: YN
authors.lastname: Demissie
authors.forename: Tarek M
authors.initials: TM
authors.lastname: Fiad
authors.forename: Katja
authors.initials: K
authors.lastname: Klemm
authors.forename: Afaf
authors.initials: A
authors.lastname: Twfeeg
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Amoudi
authors.forename: Lorna
authors.initials: L
authors.lastname: Meer
authors.forename: Tarik A
authors.initials: TA
authors.lastname: Elhadd
mesh_terms: D000328:Adult; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D047495:PPAR gamma / Q000187:drug effects*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000188:drug therapy / Q000453:epidemiology*; D011272:Pregnancy, Multiple; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014427:Twins
chemical_list: D007004:Hypoglycemic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D008687:Metformin