Fertility Drug Metformin Pcos
Metformin belongs to a class of fertility drugs known as antihyperglycemics and it is used to treat Type II diabetes. These patients are hyperinsulinemic meaning they have abnormally elevated levels of insulin. Metformin increases the pancreatic cells sensitivity to insulin thus lowering insulin levels and reversing hyperinsulinemia. When a patient is insulin resistant it means that her body tries to compensate for lower insulin levels by overproducing insulin. When the cells are sensitized to insulin (increased sensitivity) by Metformin, circulating levels of insulin decline. Polycystic ovarian syndrome (PCOS) patients often have chronically elevated insulin levels (hyperinsulinemia) leading to overproduction of androgens (male hormones) by the ovaries, increased LH production, often obesity, ovaries covered with many unruptured cysts, excess body or facial hair, irregular or no ovulation , and infertility . If abnormally elevated insulin levels are corrected, ovulation will often resume. This is because when insulin levels decline the ovary reduces it production of androgens. PCOS patients can suffer serious long term health consequences of chronically elevated androgen levels. Oftentimes they have a significantly increased risk of cardiovascular disease and diabetes. For this reason, some specialists choose to administer Metformin to PCOS patients long term in addition to acute treatment for infertility. Metformin differs from Clomid and FSH in that it does not directly stimulate ovulation rather it corrects a physiologically abnormal condition (chronic hyperinsulinemia) thus allowing natural ovulation to resume. Metformin can be used as solo therapy or combined with FSH , Clomid or letrozole (Femara). Some studies have shown PCOS patients respond better to Metformi Continue reading >>
Metformin In The Treatment Of Infertility In Pcos: An Alternative Perspective
Metformin in the Treatment of Infertility in PCOS: An Alternative Perspective Departments of Internal Medicine, Obstetrics and Gynecology, and Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298 John E. Nestler, Departments of Internal Medicine, Obstetrics and Gynecology, and Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298; Address all correspondence and reprint requests to: John E. Nestler, M.D., Division of Endocrinology and Metabolism, Medical College of Virginia, P.O. Box 980111, Richmond, VA 23298-0111 The publisher's final edited version of this article is available at Fertil Steril See other articles in PMC that cite the published article. This editorial discusses the recent ESHRE/ASRM recommendations on the treatment of infertility in PCOS. Evidence is provided for the use of metformin in selected patients. In 2007, the European Society for Human Reproduction and Embryology (EHSRE) and the American Society for Reproductive Medicine (ASRM) sponsored a workshop to discuss the therapeutic challenges of infertility and the polycystic ovary syndrome (PCOS), out of which a consensus paper emerged ( 1 ). The consensus statement offered a bleak view of the use of metformin in infertility, recommending that metformin use in PCOS should be restricted to women with glucose intolerance. In this editorial, I offer a perspective on the use of metformin for the treatment of infertility in PCOS that differs significantly from the consensus statement. My aim is to provide a strategy that addresses the needs not only of the reproductive endocrinologist, whose patients often desire pregnancy immediately, but also the gynecologist, medical endocrinologist and others, whose patients' time lines for achieving pregnancy Continue reading >>
Can Metformin Help Women With Pcos?
Home / Fertility / Boosting Fertility We asked doctors whether the drug Metformin really helps women with PCOS conceive, reduce miscarriage risk and increase milk supply. Here's what they say. If you have polycystic ovary syndrome (PCOS), you're not alone. According to the National Center for Biotechnology Information , this hormonal disorder affects between 5 percent and 15 percent of women of reproductive age in this country. In polycystic ovary syndrome, cysts develop on the ovaries, and the body produces excess hormones called androgens, which cause an irregular menstrual cycle. As a result, ovulation can be unpredictable, and getting pregnant can be challenging. "Since puberty, I've averaged one menstrual cycle per year," says Carrie, a mother from the Midwest who has PCOS. "I always wondered if I could have children." Carrie tried getting pregnant for several months, but wasn't able to because she wasn't ovulating. After evaluating her bloodwork, her OB/GYN suggested she go on either Clomid or Metformin to help balance her hormones to promote ovulation. "Because I had a very slight imbalance in my hormones, my doctor suggested trying Metformin before going straight to Clomid. Since I heard horror stories about Clomid causing multiples, I was happy to try Metformin first," Carrie says. Metformin is a diabetes medication that is sometimes used to regulate hormones in women with PCOS by balancing their insulin level. This effect leads to more regular menstruation and ovulation cycles , according to WebMD . Carrie got pregnant the first month she took Metformin. But not all women with polycystic ovary syndrome have such good results. In fact, experts say more evidence is needed to prove that Metformin helps conception in PCOS patients . "When putting all the data tog Continue reading >>
Fertility Medication - Metformin And Infertility
Nora Miller, MD established Womens Fertility Center as a place to assist women and their partners with reproductive issues. What is Hyperinsulinemia (insulin resistance)? Hyperinsulinemia, or elevated blood insulin levels, is an endocrine disorder most oftenfound in patients with polycystic ovarian syndrome (PCOS). PCOS is characterized byirregular or absent menstrual periods, hormone imbalances and the presence of anincreased number of small follicles on the ovaries. PCOS has several differentmanifestations. Some women with PCOS may also experience excessive hair growth,hair loss, acne, and obesity. How is Hyperinsulinemia related to infertility? Hyperinsulinemia is believed to cause a hormonal imbalance in the pituitary gland andovary. This leads to an increased level of lutenizing hormone (LH). Increased levels ofLH are then believed to cause ovulation disorders, menstrual irregularities andinfertility. Metformin (Glucophage) is an oral fertility medication which can help lower insulin levels and improve ovulation patterns. Metformin is FDA approved for the treatment of PCOS and Type II diabetes. By better regulating blood glucose, many women find that while taking metformin they are more easily able to lose weight. Of course, taking metformin is not the solution alone. It must be taken in conjuction with lifestyle changes. Specifically, eating a high protein, low carbohydrate diet and getting regular exercise. Some women are able to lose enough weight that they are able to resume ovulating and menstruating spontaneouslyand thePCOS resolves. Continue reading >>
The Role Of Metformin In Pcos-related Infertility
The Role of Metformin in PCOS-Related Infertility Polycystic Ovary Syndrome: The Role of Metformin Polycystic ovary syndrome (PCOS) affects 3%-8% of reproductive-age women. It is characterized by clinical and laboratory hyperandrogenism; polycystic, enlarged ovaries; and irregular menstrual cycles. Various diagnostic criteria are in use, but the most widely applied are the Rotterdam criteria, which require two of three features to be present.[ 1 , 2 ] PCOS may present with various clinical problems, such as hyperandrogenism, oligo- or amenorrhea, obesity, the metabolic syndrome, or infertility. Metabolic problems mediated through insulin resistance (IR) are a common feature of PCOS. Women with PCOS produce more insulin to maintain normal glucose levels. The degree of IR varies in different tissues; it is present in the liver and skeletal muscles, but the ovaries show less IR. The benefits of insulin sensitizers have long been studied in women with PCOS. Metformin is an insulin-sensitizing agent that reduces glucose absorption and hepatic glucose synthesis and increases glucose uptake in skeletal muscles. Furthermore, through gastrointestinal side effects, it often results in weight loss. It has long been studied alone or in combination with other agents to restore ovulation. A new guideline from the practice committee of the American Society for Reproductive Medicine[ 3 ] reviews the evidence for the use of metformin for ovulation induction. Studies evaluating the use of metformin for PCOS are heterogeneous; different diagnostic criteria have been used, some have evaluated lean women and others obese women, some screened for IR whereas others did not, insulin sensitivity was measured by different tests, and outcome parameters have varied. This heterogeneity limits the Continue reading >>
10 Facts About Metformin And Pcos
Polycystic ovary syndrome (PCOS) is a relatively common hormonal disorder that is one of the leading causes of infertility. Some women who have PCOS develop insulin resistance. This occurs when the cells of the body don’t respond well to a hormone known as insulin. Insulin allows the cells to take sugar (glucose) from the blood. If the cells don’t take in this sugar it leads to higher levels of glucose and insulin circulating through the body in the bloodstream. This, in turn, leads to increased levels of androgens (male hormones) which cause the classic symptoms of PCOS such as excess hair growth and more importantly in terms of fertility – lack of ovulation. Getting pregnant with PCOS can be possible with the right diagnosis and treatment plan. Here are the Top 10 facts about metformin use in PCOS patients: 1) Metformin is a medication that is primarily used to treat type 2 diabetes. It is marketed in the US under the names Fortamet, Glucophage, Glucophage XR, Glumetza and Riomet. It is available as a tablet, extended-release tablet and a liquid. 2) With infertility patients, it is used not because the women with PCOS have diabetes (although they do have an increased risk of developing this disease), but because it acts on improving use of insulin by the cells of the body and therefore reducing the level of insulin in the blood. This can lead to improved ovulation, more regular menstrual cycles as well as a reduction in excessive hair growth, acne and weight gain. It may also slow down or prevent the development of type 2 diabetes later in life. 3) To determine if it would be helpful for a patient with PCOS to use Metformin, they are given a 2 Hour Glucose Tolerance Test. First, a fasting blood sample is drawn to determine a baseline glucose level. The patient t Continue reading >>
Does Metformin Make You More Fertile?
It's an increasingly common phenomenon: A drug that was originally synthesized for a specific purpose turns out to be effective in combating another problem. Examples include Viagra (an unsuccessful treatment for angina that succeeded as an erectile dysfunction drug) and Thalidomide, a disastrously ineffective medication for pregnancy-induced nausea that has been proven to fight bone marrow cancer [source: Brown]. Metformin can also be included in this list, but with one significant difference. Not only is it helpful in a secondary role, but it's wildly popular in treating the condition for which it was initially intended. Metformin was developed in the 1950s as a treatment for diabetes [source: Diabetes Forecast]. Today it's the most popular drug on the market for people with Type 2 diabetes [source: Science Daily]. But by 2004, Metformin was receiving international acknowledgement as a worthwhile option for patients seeking a remedy for their infertility. The U.K.'s National Collaborating Centre for Women and Children's Health noted that the drug, when used in conjunction with other medications, improved the rate of pregnancy in women with specific infertility issues tied to ovaries containing multiple cysts [source: NCCWCH]. The common denominator between Type 2 diabetes, Metformin and infertility can be described in one word: insulin. Insulin carries blood sugar to the body's cells to create energy. Some people's bodies, however, produce too little insulin, or the cells in the body refuse to accept the sugar it's transporting [source: American Diabetes Association]. That can lead to a multitude of health issues. Women whose infertility is tied to polycystic (multiple cysts) ovarian syndrome often have issues with insulin resistance. That's where Metformin comes in. Continue reading >>
Glucophage | Ivf1
Each of the studies below are currently recruiting patients to enroll. Click each option to learn more Each of the studies below are currently recruiting patients to enroll. Click each option to learn more There are many reasons why a woman may not ovulate regularly. It appears that some women are resistant to the hormone insulin. Insulin is normally thought of as the hormone produced by the pancreas that helps regulate blood sugar. While this is true, insulin also has many other effects in the body. The ovary has receptors for insulin and thus insulin is capable of modifying hormone production from the ovaries. The are several conditions that may result in a woman becoming resistant to the effects of insulin. Among these are PCOS Polycystic Ovary Syndrome genetics and obesity. When insulin resistance occurs, the body needs a higher level of insulin to accomplish the same tasks. High insulin levels are frequently seen in this condition. If insulin resistance is the cause for a womans anovulation (not ovulating) then it stands to reason that improving the insulin resistance or lowering the insulin levels may be successful at causing ovulation to return. In fact some studies in overweight women with insulin resistance demonstrated that Metformin (Glucophage) was successful in getting ovulation to occur without any other additional medications. It also seemed to improve the response to a fertility medication called clomiphene citrate. Results of the Worlds Largest Metformin Study Recently, a study was published comparing metformin to clomid in patients with PCOS. This study was conducted on over 600 patients and involved several academic centers. There were three groups of patients that were compared. Group 1 took metformin alone. Group 2 too clomid alone. Group 3 took a Continue reading >>
What Is Metformin Used For In Infertility Treatments?
What is metformin used for in infertility treatments? PCOS , Trying to Get Pregnant No comments Metformin, also known as Glucophage, is a medication used for Type 2 diabetes. Metformin is taken orally. Metformin helps the body respond better to insulin; this then helps the body metabolize the sugar glucose. The female reproductive system, particularly the ovaries, requires insulin to work properly. When there is an excess of insulin in the body, the ovaries may not function normally. Thus, there is a basic relationship between insulin and pregnancy. This relationship becomes especially important for women with PCOS. PCOS (Polycystic Ovarian Syndrome) is a common cause of infertility. The ovaries of women with PCOS contain many small cysts, hence the name polycystic. Women with PCOS often do not ovulate regularly and have irregular menstrual cycles. Many physicians and fertility experts attempt to treat PCOS with a drug called clopimhene or Clomid. Clomid helps to induce ovulation. In recent years, Metformin has been used, either with or without Clomid, to help produce ovulation in women with PCOS. Metformin assists the body with responding to and managing its insulin; in turn, this helps the ovaries function more regularly, and creates a more regular ovulation cycle. This assists greatly when trying to conceive. Some studies have suggested that the use of metformin also can help reduce the risk of miscarriage. Additionally, the use of metformin may reduce the risk of gestational diabetes, and may delay or prevent the onset of Type 2 diabetes. Side effects of metformin can include abdominal pain or cramping, discomfort, and nausea. The use of metformin may inhibit the absorption of Vitamin B12. Your physician may recommend vitamin supplements and/or dietary changes to a Continue reading >>
Glucophage (Metformin) for the Treatment of PCOS Polycystic ovary syndrome (PCOS) is a common condition characterized by failure to ovulate (and irregular menstrual periods), a tendency toward excess body hair and acne and/or oily skin. It is estimated that one in twenty reproductive age women have PCOS. While this is a common problem in the infertile population, the cause of this condition is still not completely understood. There is new information to suggest that the underlying cause in many women with PCOS is insulin resistance. Women with this condition are not diabetic-their blood sugar levels are normal-however, their insulin levels are frequently elevated. Lowering the insulin levels acts to decrease elevated levels of male-type hormones (such as Testosterone) and, in many cases, restores ovulation and normal fertility. Treatment of infertility for women with PCOS is ovulation induction with clomiphene citrate (Clomid, Serophene) and/or metformin. For those who fail to ovulate in response to clomiphene citrate alone, treatment with Metformin may be added. Metformin does not have a F.D.A. indication for its use in PCOS but there is substantial research on the application of Metformin in this setting and Metformin is being used at reproductive endocrinology and infertility clinics around the world for this common problem. Metformin has no effect on insulin production per se but facilitates insulin action in the body so that the body will naturally make less of it. It should not be used in women with insulin-dependent diabetes, liver dysfunction, kidney disease, or who are exposed to IVP dye (for X-ray testing of the kidneys). It should not be used in times of acute physical stress such as severe illness (influenza), surgery or recovery from significant trauma. Deh Continue reading >>
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Glucophage Drug & Infertility Treatment Last Updated On Dec 29, 2012 By Alyssia Granger
Free Gift! 20 Pregnancy or Ovulation Tests Glucophage was not designed or developed as a fertility treatment, but it has been shown to help with some aspects of fertility. Glucophage, also known as Metformin , is a medication used as a fertility treatment that is a little bit out of the box, so to speak. Glucophage was not designed or developed as a fertility treatment, but it has been shown to help with some aspects of fertility. Lets find out more about Glucophage and what it can do to help with fertility. Claim Your 20 Free Pregnancy Tests Click Here Glucophage is primarily used as a drug to treat Type 2 Diabetes . Its job is to help the body respond more effectively to insulin. It helps to improve blood sugar levels in Diabetes patients. For women with PCOS , Glucophage can be a helpful way to regulate the erratic insulin levels that PCOS can cause. The ovaries can not work properly without the proper levels of insulin, so Glucophage can help to maintain those levels. Some doctors also think that it is a good idea to use Glucophage once you do become pregnant, to decrease risk of miscarriage, and help to avoid developing gestational diabetes. Glucophage is an oral medication, and it is usually very well tolerated. It is sometimes combined with Clomid for even better results. Glucophage is considered to be a helper drug. That is, it does not induce ovulation on its own, but it helps the body get to a better place where it can handle insulin on its own and ovulation can resume normally. It has been shown to be very effective in women with PCOS, or who are otherwise insulin resistant. While Glucophage is generally well tolerated in patients, sometimes it can have a few negative side effects. The most common side effects are gastrointestinal ones, stomach ache, vomitin Continue reading >>
Polycystic Ovarian Syndrome Fertility Treatment With Metformin (glucophage)
How Metformin Is Used for Polycystic Ovaries Polycystic ovarian syndrome is a common cause of anovulation and infertility in women. These women do not ovulate (release eggs) regularly and therefore have irregular menstrual periods. The ovaries have many small cysts (2-7 mm diameter) called antral follicles, giving the ovaries a characteristic "polycystic" (many cysts) appearance on ultrasound. A relatively new method of treating ovulation problems in women with polycystic ovarian disease is to use an oral medication called metformin (brand name is Glucophage). Metformin has traditionally been used as an oral drug to help control diabetes. Then, some smart doctor figured out that polycystic ovarian syndrome treatment with metformin can be very effective. If Glucophage alone does not result in ovulation and pregnancy, we often use: If the combination therapy is not effective, we can try: Metformin Use with IVF Treatment We also use Glucophage in women going through in vitro fertilization for PCOS, and for those with very high antral follicle counts - if their ovaries are "polycystic" by ultrasound. We find that some women with polycystic ovaries respond with a "smoother" response to the injectable FSH medication if they have been taking Glucophage. Risks and Side Effects of Metformin / Glucophage In about 25% of women Glucophage causes side effects which may include abdominal discomfort, cramping, diarrhea and nausea. The side effects may be severe enough to make the woman stop the Glucophage medication. We are not aware of any serious complications resulting from Glucophage treatment. Another oral medication used for diabetes called Troglitazone has been associated with liver failure and death in rare cases. This has been publicized on television shows, in newspapers, et Continue reading >>
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Glucophage (metformin) For Infertility:?
glucophage , female infertility , polycystic ovary syndrome , metformin , pregnancy I am planning to get pregnant and have symptoms of PCOS. Is it advisable to take glucophage (metformin hydrochloride)? Will it help me ovulate apart from controlling my sugar levels? Will there be any side effects on fetus. My daughter has pcos and used glucophage until she did get pregnant. She did need to stop during the pregnncy. She also used it only for the pcos not for any form of diabetes. But she does have insulin resistance . So if you are on it already in my opinion and from my daughter's experience it is fine to take until you are pregnant. And I truly believe it was a factor in her being able to get pregnant. Hope this helps Good Luck and I hope you are succesfull sith getting pregnant God Bess I have the same problem and I'm trying to conceive. had surgery in Nov.2008 with a fibroid tumor removed. have an appointment next month and was searching different web sites for answers. P.S how long did it take before she got pregnant? hopefully,not long Thank you so much for your answer, which is giving me some hopes and reassurance. Did she have to take anything else lime Clomiphene to conceive? How long did it take to conceive for her? i plan to do ivf, and doc advice me to take glucophage before the progam, he told me that glucophage will help to produce a good equlity of eggs. Continue reading >>
Metformin alone has been show to improve fertility and increase a womans chances of getting pregnant and having a baby. This treatment is much more effective when combined with dietary changes that lower circulating insulin levels. Our doctors specialize in helping women overcome the challenges of insulin problems and polycystic ovarian syndrome (PCOS) using diet and metformin when necessary. Metformin is a prescription medication that should be used only as prescribed. 30% of patients may experience nausea, diarrhea, and abdominal bloating. Starting low and building up to the desired dose over several weeks may alleviate these problems. A metallic taste during initial therapy is reported in 3% of patients. 1 in 33,000 people taking metformin develop a build up of lactic acid (lactic acidosis). While this is fatal in 50% of cases, it is not likely to occur in someone without impaired liver or kidney function. The risk of lactic acidosis in a young and healthy population has been estimated to occur in less than 1 in 250,000 patients. Symptoms include: weakness, unusual muscle pain, trouble breathing, stomach discomfort, feeling cold, dizzy or lightheaded, and suddenly developing a slow or irregular heart beat. All patients on metformin should follow up regularly with a physician familiar with metformin. Continue reading >>
Polycystic Ovary Syndrome And Pregnancy: Is Metformin The Magic Bullet?
This article reviews the literature regarding the effects of metformin therapy in pregnant women with polycystic ovary syndrome on weight loss, fertility, early pregnancy loss, malformations, gestational diabetes mellitus, perinatal mortality, placental clearance, lactation, and early childhood development. The pharmacology of metformin is also presented. Preliminary data suggest that metformin for this population may be both safe and effective. Large blinded, randomized clinical trials are underway to confirm the preliminary safety data. History of Polycystic Ovary Syndrome Although the first description of polycystic ovary syndrome (PCOS) is generally credited to Stein and Leventhal in 1935, it may have been observed as early as 1721, when the Italian scientist Antonio Vallisneri observed “young married peasant women, moderately obese and infertile, with two larger than normal ovaries, bumpy and shiny, whitish, just like pigeon eggs.”1 This depiction sounds strikingly similar to the subfertility and obesity commonly found in PCOS. It was not until 1921 that Achard and Theirs2 noticed a relationship between hyperandrogenism and insulin resistance in their study of the “bearded diabetic woman.” And in 1935, Stein and Leventhal3 made the connection between amenorrhea and polycystic ovaries. In addition, they also noticed the occurrence of masculinizing changes, such as hirsutism and acne, in many patients with polycystic ovaries. Several, but not all, of Stein and Leventhal's original case studies involved women who were overweight. In all seven of their case reports, attempts to treat ovulatory dysfunction with estrogenic hormone failed, and wedge resection was employed. All of their patients gained normal menstruation, and two became pregnant. Surgery for PCOS Continue reading >>