Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome

Tso, L.O.; Costello, Michael; Albuquerque, L.E.T.; Andriolo, Régis B; Macedo, Cristiane R

doi:10.1002/14651858.cd006105.pub3

Cited by 126 publications

(86 citation statements)

References 37 publications

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“…• The use of metformin increase clinical pregnancy rate and decrease ovarian hyperstimulation syndrome (OHSS) risk during assisted reproductive technologies (ART) cycles [10].…”

Section: New Evidence-based Steps In Treating Pcosmentioning

confidence: 99%

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Elnaggar

Elwan

Ibrahim

et al. 2016

J Obstet Gynecol India

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Aim of the present study To assess the changes in hormonal profile (serum FSH, LH, prolactin and total testosterone) following laparoscopic ovarian drilling (LOD) in patients with polycystic ovarian syndrome. Materials and methods Fifty patients with PCOS have been included in this study. Serum prolactin, total testosterone, follicular-stimulating hormone (FSH) and luteinizing hormone (LH) levels have been used as biochemical markers, before and after procedures. Results Laparoscopic ovarian drilling was successfully employed without any surgical complications and on an average follow-up time of 24 weeks after the procedure. During the follow-up serum values for prolactin, total testosterone and LH have decreased significantly and FSH levels remained unchanged after the procedure. 123Conclusions The LOD in patients with PCOS may avoid or reduce the risk of OHSS and the multiple pregnancy rate induced by gonadotropin therapy. The high pregnancy rate and the economic aspect of the procedure offer an attractive management for patients with PCOS. However, LOD can be considered as second-line treatment after clomiphene citrate treatment failure and/or resistance.

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“…• The use of metformin increase clinical pregnancy rate and decrease ovarian hyperstimulation syndrome (OHSS) risk during assisted reproductive technologies (ART) cycles [10].…”

Section: New Evidence-based Steps In Treating Pcosmentioning

confidence: 99%

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Elnaggar

Elwan

Ibrahim

et al. 2016

J Obstet Gynecol India

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“…While studies have demonstrated a decreased rate of OHSS with metformin administration for PCOS patients undergoing IVF [22], a randomized placebo controlled study did not show decreased rates of severe OHSS for patients with polycystic ovarian morphology [20]. Still, other techniques used to control for OHSS in PCOS patients such as agonist trigger have been shown to be successful in decreasing OHSS risks PCO patients [11].…”

Section: Discussionmentioning

confidence: 99%

The clinical ramifications of polycystic ovarian morphology in oocyte donors

Cho

Ambartsumyan

Danzer

et al. 2013

J Assist Reprod Genet

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Objective To determine the relationship between Polycystic Ovary (PCO) morphology and In Vitro Fertilization (IVF) outcome in oocyte donation cycles. Design Cross sectional study Setting Private IVF clinic Patients 164 consecutive ovum donors and their recipients were reviewed, 149 were included in the study where 113 patients had normal ovarian morphology and 36 patients had PCO morphology. Interventions All donors underwent ovarian stimulation in conjunction with GnRH agonist or antagonist in standard fashion. Main Outcome Measures Baseline donor characteristics were recorded, as well as details of IVF stimulation and embryo data. Recipient data on pregnancy and miscarriage were also collected. Results Patients with PCO ovaries had significantly higher peak estradiol levels and required less gonadotropins during IVF stimulation. In addition, the baseline characteristics between donor groups did not differ except for ovarian morphology. The number of oocytes retrieved and indicators of embryo quality did not differ between the two groups, and there was no significant difference between pregnancy and miscarriage rates in the recipients. Conclusions Oocyte donors with PCO morphology have equivalent pregnancy rates and do not need to be excluded as potential donors.

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“…7 Cochrane review reported that metformin increased clinical pregnancy rates and reduced OHSS risk with no effect on live birth rate. 8 Smith et al have supported use of adjuvant metformin as a strategy for OHSS prevention starting at least 2 months before controlled ovarian stimulation. 9 Turan et al demonstrated that although MI was similar to metformin in prevention of OHSS, but increase in the ovarian diameter was the smallest in the MI treated group.…”

Section: Discussionmentioning

confidence: 99%

A unique variant of spontaneous ovarian hyperstimulation syndrome: case report

Rohatgi

Buckshee²

2017

Int J Reprod Contracept Obstet Gynecol

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Spontaneous ovarian hyperstimulation syndrome (SOHSS) is extremely rare in naturally conceived pregnancies and is potentially a life-threatening condition. Objective of present study was to highlight the development of new and atypical findings associated with SOHSS in a woman who conceived naturally with singleton pregnancy while taking inositols and metformin. A 35 years old lady was under pressure to conceive, so she presented to us for fertility consultation and further management. Being a case of polycystic ovary syndrome (PCOS) with irregular periods, hyperandrogenism and dyslipidemia with raised blood sugar level, she was started on inositols and metformin to aid fertility and to improve endocrine and metabolic parameters. To evaluate the status of ovaries and endometrium, ultrasound (US) was done which revealed moderate amount of free fluid in pelvis, thickened endometrium and mild enlargement of ovaries with unusually small and atypical follicles. Pregnancy test and beta-human chorionic gonadotropin (βHCG) confirmed pregnancy. She was asymptomatic and was managed conservatively. Pregnancy progressed and at term, a healthy male baby was delivered. Awareness and suspicion of SOHSS in a PCOS case aided early diagnosis and timely management. Intake of type of pharmacological and non-pharmacological agents to be monitored for their impact on fertility, ovarian enlargement, severity of ovarian hyperstimulation syndrome (OHSS), clinical presentation, laboratory profile and outcome of pregnancy.

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Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome

Cited by 126 publications

References 37 publications

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

The clinical ramifications of polycystic ovarian morphology in oocyte donors

A unique variant of spontaneous ovarian hyperstimulation syndrome: case report

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