Effects of metformin treatment on pregnancy outcomes in patients with polycystic ovary syndrome

Raperport, Claudia; Chronopoulou, Elpiniki; Homburg, Roy

doi:10.1080/17446651.2021.1889366

Cited by 7 publications

(3 citation statements)

References 80 publications

(68 reference statements)

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“…The best-recognized treatment for PCOS today is metformin (60). As a first-line medication for type 2 diabetes, metformin helps patients better regulate their blood sugar levels (61); It is an insulin-sensitizing medication that lowers body weight and increases conception and ovulation (62). The findings of this research supported those of earlier studies.…”

Section: Discussionsupporting

confidence: 79%

Ameliorative Effect of Chitosan-Propolis Nanoparticles on the Estradiol Valerate -Induced PCOS in Rat

Hosseini¹,

Khodaei²,

Hasansagha³

et al. 2023

Preprint

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Background: Endocrine conditions that impact women define polycystic ovary syndrome. Previous studies have demonstrated a connection between PCOS and insulin intolerance, oxidative stress, and immune system dysfunction. Additionally, some reports have indicated that propolis has antioxidant properties and that chitosan nanoparticles have beneficial effects on the reproductive system. The goal of the present study is to compare metformin (Met) to chitosan-propolis nanoparticles and explain how they protect against a rat PCOS model caused by estradiol valerate (EV). (as a control treatment). Methods: In order to cause PCOS in rodents, a single subcutaneous injection of estradiol valerate was used, followed by a 42-day oral administration of 500 mg/kg of chitosan-propolis nanoparticles. Four sets of rats were created: the control, PCOS, metformin (PCOS and 150 mg/kg metformin), and chitosan-propolis nanoparticle (PCOS and 500 mg/kg chitosan-propolis nanoparticle) groups. The histopathological examination of the ovaries and measurement of serum ferctors were performed on all of the animals. Estradiol valerate caused PCOS, but chitosan-propolis nanoparticle therapy reversed it. Results: After chitosan-propolis nanoparticle intervention, the body weight and ovarian morphology had improved, and the serum biochemical parameters, including esretogen, progestron, vitamin D, calcium, and the insulin resistance index, had been corrected. These EV-induced changes include decreased SOD activity, elevated MDA levels, and evidence that oxidative stress was increased by EV when chitosan-propolis nanoparticle/Met were administered for 42 straight days. Additionally, certain relative mRNA transcripts, including those for the MCP, IL18, and CRP genes, were markedly upregulated in EV-treated animals. These findings unequivocally demonstrate the beneficial effects of chitosan-propolis nanoparticles/Met in inflammatory disorders. Conclustion: Together, the study's end findings, which are presented here, are consistent with the hypothesis that chitosan-propolis nanoparticle/Met offered protective activity against the harmful effects of EV. Although ameliorative effects may have been implicated, the primary pathway or pathways still need to be clarified.

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Section: Discussionsupporting

confidence: 79%

Ameliorative Effect of Chitosan-Propolis Nanoparticles on the Estradiol Valerate -Induced PCOS in Rat

Hosseini¹,

Khodaei²,

Hasansagha³

et al. 2023

Preprint

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“…Studies have reported that insulin-sensitizing agents such as metformin lower the rate of miscarriage in women with PCOS. [ 23 ] Metformin has been found to reduce the level of PA inhibitor by decreasing the insulin level and alleviating IR. [ 24 ] This eventually improves uterine vascularity.…”

Section: Discussionmentioning

confidence: 99%

High Insulin Resistance in Saudi Women with Unexplained Recurrent Pregnancy Loss: A Case–control Study

Alghamdi,

Alotaibi

2023

Saudi Journal of Medicine &Amp; Medical Sciences

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Background: Unexplained recurrent pregnancy loss (RPL) accounts for >50% of the patients with RPL. Insulin resistance (IR) is a potential cause of unexplained RPL. Objectives: To evaluate the relationship between insulin resistance (IR) and unexplained RPL among Saudi women. Methods: This is a single-center, case–control study conducted at a tertiary hospital in the Eastern Province of Saudi Arabia. The study group comprised Saudi women with unexplained RPL, while the control group had Saudi women with at least one live birth and no RPL. Blood samples were taken to determine the fasting glucose (FG) and fasting insulin (FI) levels. Women with diabetes mellitus and polycystic ovarian syndrome were excluded. A homeostatic model assessment of insulin resistance index (HOMA-IR) value ≥3 was considered as IR. Results: The study and control groups comprised 43 and 56 women, respectively. Between the groups, there was a significant difference in the mean age (case: 37.9 ± 5.4 years; control: 32.2 ± 5.9 years; P < 0.0001) and the mean BMI (case: 31.5 ± 6.0; control: 26.1 ± 2.8; P < 0.0001). FG level was slightly higher in the control group (90.9 mg/dL vs 88.7 mg/dL; P = 0.068). FI level was significantly higher in the study group (16.33 μU/mL vs. 6.17 μU/mL; P < 0.0001). HOMA-IR of ≥3 was significantly more common in the study group ( n = 22; 51.2%) than the control group (4; 7.1%) ( P < 0.0001). After adjusting for age and BMI, IR ≥3 was found to be independently associated with unexplained RPL (aOR: 13.2; 95% CI: 3.77–46.36). Conclusions: This study showed that Saudi women with unexplained RPL had significantly higher levels of fasting insulin and insulin resistance than those without a history of RPL. Therefore, it is recommended to assess IR in women with RPL.

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“…In addition to these effects, MET significantly increases ovulation rate compared with placebo [ 21 , 22 ]. However, evidence regarding its efficacy in optimizing both fertility and pregnancy outcomes is inconclusive [ 23 ], and treatment with MET may not be sufficient for addressing reproductive dysfunction in patients with PCOS [ 24 ]. Indeed, a recent meta-analysis showed that treatment with MET resulted in very limited improvement in pregnancy and live birth rates compared with placebo [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Exenatide Versus Metformin in Patients with Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials

Yan

Liao

et al. 2023

Reprod. Sci.

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Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects women of childbearing age, resulting in reproductive dysfunction, hyperinsulinemia, and obesity. While several drugs are currently approved for use in these patients, their relative effectiveness remains controversial. The purpose of this meta-analysis was to evaluate the reproductive efficacy and safety of exenatide, a glucagon-like peptide-1 receptor agonist, versus metformin, an insulin sensitizer, in the treatment of patients with PCOS. Nine randomized controlled trials (RCTs) were included, comprising 785 PCOS patients, of whom 385 received exenatide and 400 received metformin. Compared with metformin, exenatide was significantly more effective in treating these patients, as demonstrated by increased pregnancy rate (relative risk (RR) = 1.93, 95% confidence interval (CI) 1.28 to 2.92, P = 0.002), greater ovulation rate (RR = 1.41, 95% CI 1.11 to 1.80, P = 0.004), decreased body mass index (mean difference = − 1.72 kg/m2, 95% CI − 2.27 to − 1.18, P = 0.00001), and improved insulin resistance (standard mean difference = − 0.62, 95% CI − 0.91 to − 0.33, P < 0.0001). There was no significant difference in the occurrence of adverse events (gastrointestinal reactions, hypoglycemia, etc.) between the two therapies. However, given the moderate to high quality and possible bias of the included studies, the available evidence is inconclusive. More high-quality studies are needed to assess the effects of exenatide in order to provide stronger evidence for its use in this patient population.

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Effects of metformin treatment on pregnancy outcomes in patients with polycystic ovary syndrome

Cited by 7 publications

References 80 publications

Ameliorative Effect of Chitosan-Propolis Nanoparticles on the Estradiol Valerate -Induced PCOS in Rat

Ameliorative Effect of Chitosan-Propolis Nanoparticles on the Estradiol Valerate -Induced PCOS in Rat

High Insulin Resistance in Saudi Women with Unexplained Recurrent Pregnancy Loss: A Case–control Study

The Effectiveness and Safety of Exenatide Versus Metformin in Patients with Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials

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