Efficacy of metformin supplementation during ovarian stimulation of lean PCOS patients undergoing in vitro fertilization.
OBJECTIVE
To evaluate the effect of metformin addition during ovarian hyperstimulation on cycle parameters and outcome of in vitro fertilization (IVF) treatment in polycystic ovary syndrome (PCOS) patients with a body mass index (BMI) <28 kg/m(2).


METHODS
Retrospective review of patients' records.


METHODS
Istanbul Memorial Hospital Assisted Reproductive Treatment Unit.


METHODS
A total of 339 non-obese PCOS patients undergoing IVF were evaluated according to the supplementation of metformin.


METHODS
Cycle parameters and IVF outcomes of 220 patients given metformin were compared to those of 119 patients treated without metformin.


METHODS
Implantation and pregnancy rates.


RESULTS
Metformin co-treatment led to significantly lower peak E2 levels (3,481 pg/ml vs. 4,192 pg/ml; p <0.0001). However, gonadotropin consumption, stimulation duration, numbers of total and mature oocytes retrieved, fertilization rate, and ratio of grade I embryos developed were similar in both groups. In the metformin administered group, significantly higher implantation (25% vs. 18%; p=0.003) and pregnancy rates (58% vs. 45%; p=0.04) were achieved. Abortion and moderate-severe ovarian hyperstimulation syndrome rates were found to be similar in both groups.


CONCLUSIONS
Although metformin use was especially and strongly recommended in obese PCOS cases, its supplementation during IVF in PCOS patients with a BMI <28 kg/m(2) was observed to be beneficial and efficacious.
Kumbak
Banu
B
Department of Obstetrics and Gynecology, Yeditepe University, Istanbul, Turkey. bkumbak@yahoo.com
Kahraman
Semra
S
D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood / Q000494:pharmacology; D015232:Dinoprostone / Q000097:blood / Q000494:pharmacology; D010064:Embryo Implantation; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000453:epidemiology / Q000628:therapy; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
D001786:Blood Glucose; D006063:Chorionic Gonadotropin; D007004:Hypoglycemic Agents; D007328:Insulin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D008687:Metformin; D015232:Dinoprostone