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

Polycystic ovaries and obesity

“…Although obese women with PCOS require higher amounts of gonadotrophins for ovarian stimulation, the ideal protocol has not been identified. On the other hand, metformin administration at any stage of the IVF treatment did not improve pregnancy and live birth rates, except that the risk of the ovarian hyperstimulation syndrome (OHSS) was significantly reduced [76,77].…”

Does metformin affect the ovarian response to gonadotropins for in vitro fertilization treatment in patients with polycystic ovary syndrome and reduced ovarian reserve? A randomized controlled trial

“…Preliminary metaanalytic data (4) have demonstrated an improved ovarian response-that is, a shorter duration of ovarian stimulation and fewer gonadotropins used-in infertile patients with PCOS who were treated with metformin. However, more recently, in a metaanalysis that evaluated the effectiveness of metformin as a cotreatment during IVF cycles in women with PCOS, metformin reduced the risk of ovarian hyperstimulation syndrome (OHSS) by approximately 75% (3). To explain this effect, it has been hypothesized that metformin acts as a brake on the ovary through several, as yet unexplained, mechanisms (4).…”

Metformin use in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

“…They found that when metformin was compared to placebo or no treatment, the metformin group had higher clinical pregnancy rates (OR 1.52, 95 % CI 1.05-2.15) but there was no clear evidence of an increase in live birth rates. Risk of OHSS was lower in the metformin group (OR 0.29, 95 % CI 0.18-0.49) [22]. In light of the findings of the meta-analyses and individual studies, the effect of metformin on IVF treatment outcomes in PCOS patients is likely variable, depending to an extent on the patient's clinical phenotype.…”