The effects of metformin on clinical features, endocrine and metabolic profiles of infertile women with polycystic ovary syndrome

Abstract

Background: Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Insulin resistance appears to be a critical factor in PCOS pathogenesis. Metformin, an insulin-sensitizing agent, is thus the preferred treatment option for PCOS. However, no studies on the impact of Metformin on Vietnamese women have been performed. This study aimed to determine the effects of Metformin on the clinical features, endocrine and metabolic profiles in infertile Vietnamese women with PCOS. Methods: A clinical trial was conducted at the Center for Reproductive Endocrinology and Infertility on infertile women aged 18-40 years old with a diagnosis of PCOS from June 2018 to December 2020. Clinical, endocrine and metabolic characteristics of these patients were assessed before and after 3 months of Metformin treatment. Natural pregnancy rates, side effects and tolerance of Metformin have also been reported. Results: Among 87 women recruited in this study, the average age was 28.9 ± 3.4 years, 88.5% of women had oligomenorrhea; 18.4% were overweight/obese; and 19.5% of women with PCOS had hirsutism. The most prevalent phenotype of women with PCOS was phenotype D, which accounted for 74.9%. The mean AMH concentration was 7.27 ±3.42 ng/mL. The prevalences of metabolic syndrome and dyslipidemia among PCOS women with infertility were 14.9% and 54%, respectively. After 3 months of Metformin treatment, menstrual regularity was achieved in 30% of patients with oligomenorrhea. Metformin therapy significantly reduced weight and BMI while not impacting the other clinical features, endocrine and metabolic profiles. Side effects have been reported in 19,5% of patients, mainly digestive disorders. Despite this, 100% of women tolerated Metformin and continued treatment. 21.8% of them achieved pregnancy resulting in 14.9% live birth. Conclusions: 3-month treatment with Metformin for infertile women with PCOS may improve menstrual cycle regularity, weight, BMI, resulting in a clinical pregnancy rate of 21.8% and live birth rate of 14.9%.