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Why Is Metformin Used For Infertility?

Metformin For Pcos And Getting Pregnant

Metformin For Pcos And Getting Pregnant

Metformin and other insulin-sensitizing medications lower excess levels of insulin in the body.Besides metformin, rosiglitazone and pioglitazone are other insulin-sensitizing drugs that may be used to treat PCOS. There are several reasons why your doctor may prescribe metformin when treating your PCOS, some of them fertility related: As stated above, insulin resistance is common in women with PCOS. Metformin may be prescribed to treat insulin resistance, which may then help regulate the reproductive hormones and restart ovulation. Some research on metformin and PCOS shows that menstrual cycles become more regular and ovulation returns with the treatment of metformin. This may happen without needing fertility drugs like Clomid . However, some larger research studies did not find a benefit to taking metformin. For this reason, some doctors are recommending that metformin be used only to treat women who are insulin-resistant and not all women with PCOS regardless of whether or not they are insulin-resistant. While Clomid will help many women with PCOS ovulate, some women are Clomid-resistant . (This is a fancy way of saying that it doesn't work for them.) Some research studies have found that taking metformin for 4 to 6 months before starting Clomid treatment may improve success for women who are Clomid-resistant. Another option for women with Clomid resistance may be metformin combined with letrozole . If Clomid doesnt help you get pregnant, the next step is usually gonadotropins or injectable fertility drugs . Research has found that combination injectables with metformin may improve ongoing pregnant rates. One study found that combining metformin with injectables improved the live birth rate when compared to treatment with injectables alone. In this study, if the live Continue reading >>

Metformin In The Treatment Of Infertility In Pcos: An Alternative Perspective

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 >>

Opinion Article The Role Of Metformin In Ovulation Induction: Current Status

Opinion Article The Role Of Metformin In Ovulation Induction: Current Status

To define the exact role of metformin in ovulation induction, it is crucial to distinguish three different indications: naïve PCOS, CC-resistant PCOS and ART. In naïve PCOS: metformin as compared to placebo has been shown to improve ovulation rates, but metformin did not exert significant advantage over CC with respect to cumulative ovulation, pregnancy or live-birth rates. The combined approach of metformin plus CC is not better than CC or metformin monotherapy in naïve PCOS. In CC-resistant patients: metformin has no benefit over placebo in ovulation, pregnancy, and live-birth rates as a single agent, but the combination of metformin and CC significantly improved ovulation and pregnancy rates when compared with CC alone. However, combined therapy did not improve the odds of live birth. Metformin pretreatment improves the efficacy of CC in PCOS patients with CC resistance. In PCOS patients scheduled for ART: metformin addition to gonadotropins reduces the duration of gonadotropins administration and the doses of gonadotropins required, and increases the rate of monoovulations, reducing the risk of cancelled cycles. Metformin co-administration to IVF treatment does not improve pregnancy or live-birth rates but reduces the risk of OHSS. Continue reading >>

The Role Of Metformin In Pcos-related Infertility

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 >>

Does Metformin Make You More Fertile?

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 >>

Fertility Drugs Metformin, Glucophage Infertility Treatment

Fertility Drugs Metformin, Glucophage Infertility Treatment

Metformin has gained widespread use in the treatment of women with polycystic ovarian syndrome (PCOS) . Metformin is known as an insulin sensitizing drug or an antiglycemic and is used in treating II diabetes. Clomid is also frequently used by OB/GYNs as a first line treatment for failed ovulation. The hyperinsulinemic state in PCOS patients leads to increased insulin production and increased androgen (male hormones) production. Androgens are male hormones similar to testosterone. Most of the clinical findings of PCOS are due to elevated androgens and include dark body and facial hair, sometimes male pattern baldness, pear shaped body appearance, numerous unruptured cysts on the ovaries, and other symptoms. Continued untreated, PCOS patients can have serious future health risks such as cardiovascular disease, and diabetes. Since metformin sensitizes the cells to insulin, less insulin is needed per measure of carbohydrate. Once insulin levels decline overproduction of androgens by the ovary usually diminishes allowing normal ovulation to resume. Metformin is not an ovulation induction medication; rather it returns the hormonal milieu to normal allowing normal ovulation to resume. Fertility specialists will often continue metformin therapy to help avoid future negative health consequences. If metformin alone is insufficient, Clomid can be added. Additionally, metformin can be administered with FSH for ovulation induction. PCOS patients often have exaggerated responses to FSH which can exacerbate after the injection of hCG and become serious as in hyperstimulation syndrome. For this reason, only a board certified reproductive endocrinologist, infertility specialist with extensive clinical experience should manage these patients. This field is for validation purposes and s Continue reading >>

10 Facts About Metformin And Pcos

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 >>

Metformin Use In Women With Polycystic Ovary Syndrome

Metformin Use In Women With Polycystic Ovary Syndrome

Metformin use in women with polycystic ovary syndrome 1Robinson Institute, University of Adelaide, Adelaide, Australia; 2University of Auckland, Auckland, New Zealand; 3Repromed Auckland, 105 Remuera Road, Auckland, New Zealand; 4Auckland Gynaecology Group, 105 Remuera Road, Auckland, New Zealand; 5Fertility Plus, National Womens Health, Auckland District Health Board, Green Lane Clinical Centre, Auckland, New Zealand Received 2014 Apr 1; Accepted 2014 Apr 17. Copyright 2014 Annals of Translational Medicine. All rights reserved. This article has been cited by other articles in PMC. Polycystic ovary syndrome (PCOS) is an endocrinopathy characterised by increased resistance to insulin. Metformin is one of the longest established oral insulin sensitising agents. For decades its use was restricted to management of type 2 diabetes. However, in the past two decades, its properties as an insulin sensitising agent have been explored in relation to its applicability for women with PCOS. Metformin is an effective ovulation induction agent for non-obese women with PCOS and offers some advantages over other first line treatments for anovulatory infertility such as clomiphene. For clomiphene-resistant women, metformin alone or in combination with clomiphene is an effective next step. Women with PCOS undergoing in vitro fertilisation should be offered metformin to reduce their risk of ovarian hyperstimulation syndrome. Limited evidence suggests that metformin may be a suitable alternative to the oral contraceptive pill (OCP) for treating hyperandrogenic symptoms of PCOS including hirsutism and acne. More research is required to define whether metformin has a role in improving long term health outcomes for women with PCOS, including the prevention of diabetes, cardiovascular disease Continue reading >>

Benefits Of Metformin In Reproductive-age Women

Benefits Of Metformin In Reproductive-age Women

Benefits of Metformin in Reproductive-Age Women Metformin in Reproductive Health, Pregnancy and Gynaecological Cancer: Established and Emerging Indications Sivalingam VN, Myers J, Nicholas S, Balen AH, Crosbie EJ Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality that affects women of reproductive age and can be diagnosed in 5%-10% of them. It is characterized by oligo-ovulation, hyperandrogenism, and polycystic ovaries.[ 1 ] Insulin resistance plays an important role in its etiology. The liver and skeletal muscles are resistant to the actions of insulin, so in order to maintain euglycemia, insulin is overproduced. Insulin and insulin-like growth factor (IGF), however, act as a growth factor in the ovary and stimulate its androgen synthesis. Androgens are then responsible for hirsutism, acne, and arrested follicle development as well. Over 50% of women with PCOS are overweight or obese, which further augments insulin resistance. PCOS is not the only condition accompanied by insulin resistance. Being overweight or obese is also associated with insulin resistance. Insulin resistance, if left untreated, can ultimately result in glucose intolerance and even type 2 diabetes. This review summarizes the known and potential benefits of metformin therapy in reproductive-age women. The benefits of metformin have been extensively studied among infertile women diagnosed with PCOS. The lack of regular ovulation is usually the primary cause of infertility among them. Clomiphene citrate is the typical first-line drug administered to induce follicle growth. Metformin is also frequently prescribed to help ovulation, although randomized trials have not shown superior results when compared with clomiphene. A systematic review found improved ovulation rates with met Continue reading >>

Fertility Medication - Metformin And Infertility

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 >>

Metformin Glucophage

Metformin Glucophage

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 >>

Fertility Treatment

Fertility Treatment

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 >>

Glucophage (metformin) For Infertility:?

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 >>

Glucophage | Ivf1

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 >>

Can Metformin Help Women With Pcos?

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 >>

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