Metformin Plays Important Role for Women with PCOS During in Vitro Fertilization

Metformin is used as a treatment for non-obese women with polycystic ovarian syndrome (PCOS) as well as type 2 diabetes. Now, it has been found that Metformin is also beneficial in decreasing the risk of getting ovarian hyperstimulation syndrome (OHSS) in women with PCOS who experience in vitro fertilization (IVF), says a recent study published in the Journal of American Medical Association (JAMA): Obstetrics and Gynecology.

Chinese researchers from Zhejiang Province, China, have conducted a meta-analysis to find out the importance of Metformin treatment in women with PCOS who have undergone with IVF process. PCOS can be defined as an endocrinological disorder that affects the women’s reproductive system that causes abnormal production of androgen and disturbed metabolism. The main symptoms of PCOS included hyperandrogenism or the production of a high level of androgens in females, irregular menstrual cycle, and polycystic ovaries.

Source: Armando Hasudungan Organization

For the study purpose, the collected a sample comprised on 1123 women with PCOS that have undergone with IVF process which is also known as intracytoplasmic sperm injection and embryo transfer or assisted reproductive technology (ART) referred to as a common treatment known as for infertility in women and help the women to get pregnant. IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg which further helps the fertilized egg implant in the uterus.

Source: Delhi IVF Fertility Research Center

As per the UQ research center, around 4% of all children born in Australia are the result of IVF, and around one-fourth of Australian women above 40 age have experienced IVF. The rate of IVF drooped by 35% and 8% in women who are under 30 and above 40, respectively.

The current study included 12 randomized clinical trials o 1123 women with PCOS that have gone through IVF treatment. The data were extracted by two authors including Yiqing Wu and Mixue Tu from PubMed, Embase, and Cochrane.

Source: JAMA

Areas of Interest: The team aimed to check the association between Metformin treatment and the rate of catching OHSS that can be defined as a condition in which excessive response of hormones caused by medicines such as injectable gonadotropins that are mainly used to make eggs grow. The condition represents common symptoms such as abdominal pain, rapid weight gain, nausea or vomiting, and blood clots in legs.

It has been found that moderate to severe cases of OHSS is prevalent between 3.1% to 8% in the IVF treatment process, according to an estimation by Hindawi: Obstetrics And  Gynecology International.

The second area of interest of the team was to assess the complications related to the body mass index (BMI) of the women with PCOS which is 3% to 10% prevalent in the general population, according to The National Center for Biotechnology Information (NCBI).

Source: PCOS Challenge

The researchers used statistical techniques including random-effect models with the Mantel-Haenszel method for the estimation of treatment effect.

The investigators found out a decreased risk of developing OHSS in those women who received Metformin treatment in comparison to those women who did not receive the dose of Metformin.

Source: JAMA

The team also determined that those women who received Metformin treatment and their BMI were equals to or greater than 26 had a connection with an improved clinical pregnancy rate. Experts suggest aiming for a normal body mass index (BMI) between 18.5 to 24.9. If the range goes up to 30 to 39.9, then a person’s chances of developing a T2M shoot tremendously because obesity has a direct link with T2M.

Source: JAMA

Therefore, the Metformin treatment should be considered for those women who have a BMI of ≤ 26. Whether the treatment has been widely used but still there is a need that Metformin should be used very carefully for those women with PCOS who have undergone the IVF process.

Source: JAMA

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