Fertility and Sterility
Volume 90, Issue 1 , Pages 14-16 , July 2008

Metformin in the treatment of infertility in polycystic ovarian syndrome: an alternative perspective

  • John E. Nestler, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests: John E. Nestler, M.D., Division of Endocrinology and Metabolism, Medical College of Virginia, P.O. Box 980111, Richmond, VA 23298-0111 (FAX: 804-828-8389).

Received 8 April 2008 ,Revised 25 April 2008 ,Accepted 29 April 2008.

References 

  1. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril. 2008;89:505–522
  2. Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, et al. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med. 2007;356:551–566
  3. Moll E, Bossuyt PM, Korevaar JC, Lambalk CB, Van DV. Effect of clomifene citrate plus metformin and clomifene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome: randomised double blind clinical trial. Brit Med J. 2006;332:1485–1490
  4. Baillargeon JP, Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Nestler JE. Effects of metformin and rosiglitazone, alone and in combination, in nonobese women with polycystic ovary syndrome and normal indices of insulin sensitivity. Fertil Steril. 2004;82:893–902
  5. Essah PA, Apridonidze T, Iuorno MJ, Nestler JE. Effects of short-term and long-term metformin treatment on menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril. 2006;86:230–232
  6. Palomba S, Orio F, Falbo A, Russo T, Tolino A, Zullo F. Clomiphene citrate versus metformin as first-line approach for the treatment of anovulation in infertile patients with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92:3498–3503
  7. Palomba S, Orio F, Falbo A, Manguso F, Russo T, Cascella T, et al. Prospective parallel randomized, double-blind, double-dummy controlled clinical trial comparing clomiphene citrate and metformin as the first-line treatment for ovulation induction in nonobese anovulatory women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:4068–4074
  8. Nestler JE. Metformin for the treatment of the polycystic ovary syndrome. N Engl J Med. 2008;358:47–54
  9. Creanga AA, Bradley HM, McCormick C, Witkop CT. Use of metformin in polycystic ovary syndrome: a meta-analysis. Obstet Gynecol. 2008;111:959–968
  10. Nestler JE, Jakubowicz DJ, Evans WS, Pasquali R. Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome. N Engl J Med. 1998;338:1876–1880
  11. Sinawat S, Buppasiri P, Lumbiganon P, Pattanittum P. Long versus short course treatment with metformin and clomiphene citrate for ovulation induction in women with PCOS. Cochrane Database Syst Rev. 2008;1:CD006226
  12. Lobo RA, Gysler M, March CM, Goebelsmann U, Mishell DR. Clinical and laboratory predictors of clomiphene response. Fertil Steril. 1982;37:168–174
  13. Dunaif A. Drug insight: insulin-sensitizing drugs in the treatment of polycystic ovary syndrome—a reappraisal. Nat Clin Pract Endocrinol Metab. 2008;4:272–283
  14. Golay A. Metformin and body weight. Int J Obes (Lond). 2008;32:61–72
  15. Harborne LR, Sattar N, Norman JE, Fleming R. Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses. J Clin Endocrinol Metab. 2005;90:4593–4598
  16. Pasquali R, Gambineri A, Biscotti D, Vicennati V, Gagliardi L, Colitta D, et al. Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome. J Clin Endocrinol Metab. 2000;85:2767–2774
  17. Gambineri A, Pelusi C, Genghini S, Morselli-Labate AM, Cacciari M, Pagotto U, et al. Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2004;60:241–249
  18. Barbieri RL. Clomiphene versus metformin for ovulation induction in polycystic ovary syndrome: the winner is…. J Clin Endocrinol Metab. 2007;92:3399–3401

 J.E.N. has nothing to disclose.

 Supported by National Institutes of Health grant nos. R01HD35629, K24HD40237, U54HD034449, and D43TW007692.

PII: S0015-0282(08)01011-X

doi: 10.1016/j.fertnstert.2008.04.073

Fertility and Sterility
Volume 90, Issue 1 , Pages 14-16 , July 2008

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