title: Metformin reduces risk of ovarian hyperstimulation syndrome in patients with polycystic ovary syndrome during gonadotropin-stimulated in vitro fertilization cycles: a randomized, controlled trial.
abstract: OBJECTIVE
  To test whether metformin administration reduces the incidence of ovarian hyperstimulation syndrome (OHSS) in infertile high-risk patients with polycystic ovary syndrome (PCOS) who have been treated with gonadotropins for IVF.
  
  
  METHODS
  Parallel, randomized, double-blind, placebo-controlled clinical trial.
  
  
  METHODS
  Academic departments, general hospital, and IVF centers.
  
  
  METHODS
  One hundred twenty patients with PCOS at high risk for OHSS.
  
  
  METHODS
  Gonadotropins ovarian stimulation for IVF and metformin (500 mg three times daily) or placebo tablets (three times daily).
  
  
  METHODS
  The primary end point of the current clinical trial was the rate of OHSS. Anthropometric and reproductive data were evaluated.
  
  
  RESULTS
  The total OHSS and cancellation rates were significantly reduced in patients treated with metformin. The relative risk for OHSS was of 0.28 (95% confidence interval, 0.11-0.67). With metformin the stimulation length and the total amount of gonadotropins used were significantly increased, whereas the peak E(2) levels were significantly reduced.
  
  
  CONCLUSIONS
  In patients with PCOS who are at high risk for OHSS and who have been stimulated with gonadotropins for IVF cycles, metformin reduces the risk of OHSS by modulating the ovarian response to the stimulation. REGISTRATION ID NUMBER FROM CLINICALTRIALS.GOV: NCT01233206.
authors: Department of Obstetrics and Gynecology, University Magna Graecia, Catanzaro, Italy. stefanopalomba@tin.it
authors: Stefano
authors: S
authors: Palomba
authors: Angela
authors: A
authors: Falbo
authors: Laura
authors: L
authors: Carrillo
authors: Maria Teresa
authors: MT
authors: Villani
authors: Francesco
authors: F
authors: Orio
authors: Tiziana
authors: T
authors: Russo
authors: Annalisa
authors: A
authors: Di Cello
authors: Fulvio
authors: F
authors: Cappiello
authors: Sabina
authors: S
authors: Capasso
authors: Achille
authors: A
authors: Tolino
authors: Annamaria
authors: A
authors: Colao
authors: Pasquale
authors: P
authors: Mastrantonio
authors: Giovanni Battista
authors: GB
authors: La Sala
authors: Fulvio
authors: F
authors: Zullo
authors: Ettore
authors: E
authors: Cittadini
mesh_terms: D000284:Administration, Oral; D000328:Adult; D004311:Double-Blind Method; D015536:Down-Regulation / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000379:methods; D010919:Placebos; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D006062:Gonadotropins; D007004:Hypoglycemic Agents; D010919:Placebos; D008687:Metformin