Metformin in the treatment of clomiphene citrate-resistant women with polycystic ovary syndrome undergoing in vitro fertilisation treatment: a randomised controlled trial.
This study was conducted to determine the efficacy of metformin vs placebo in women with polycystic ovary syndrome (PCOS) undergoing IVF treatment. A total of 66 CC-resistant patients were studied prospectively. The women were randomly assigned to receive 850 mg of metformin (n = 34) or placebo (n = 32) twice daily that started 1 month before commencing the IVF treatment and continued to the day of the pregnancy test. Compared with the metformin-treated group, women who received a placebo had a significant increase in terms of days of stimulation with HMG, number of HMG ampoules, number of follicles >14 mm, number of oocytes retrieved, number of mature eggs, fertilisation rate and oestradiol level on the day of hCG administration. Similarly, women in the placebo group showed a significant increase in poor quality embryos, cancellation rate and the rate of ovarian hyperstimulation syndrome, as compared with the metformin-treated group. On the other hand, women who received metformin showed a significantly higher number of good quality embryos and implantation rate when compared with the placebo controls. Despite the transfer of a similar number of embryos, an insignificant increased in the pregnancy rate along with significant reduction in the abortion rate was observed in the metformin-treated group as compared with the placebo controls. No fetal abnormalities were encountered in the babies born in the metformin-treated group. It is concluded that metformin affects positively the quality of both oocytes and embryos without a significant increase in the pregnancy rate. It decreases significantly the rates of abortion and ovarian hyperstimulation syndrome.
Qublan
H S
HS
Royal Medical Services, IVF Center, Prince Rashed Hospital, Jordan. hqublan@yahoo.com
Al-Khaderei
S
S
Abu-Salem
A N
AN
Al-Zpoon
A
A
Al-Khateeb
M
M
Al-Ibrahim
N
N
Megdadi
M
M
Al-Ahmad
N
N
D000328:Adult; D002996:Clomiphene; D005260:Female; D005300:Fertility Agents, Female; D005307:Fertilization in Vitro; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin