Metformin improves IVF results in overweight women with PCOS: JAMA
Zhejiang, China: Metformin treatment decreases the risk of ovarian hyperstimulation syndrome (OHSS) but does not affect the overall pregnancy rate or live birth in PCOS women undergoing assisted fertilization (IVF/ICSI-ET), finds a new study. However, for women with a BMI of 26 or higher, metformin treatment increased the clinical pregnancy rate.
Findings of the study, published in the journal JAMA Network Open, suggest that metformin treatment should be carefully considered in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). The treatment may be more preferred for women having a BMI greater than 26.
Metformin is a widely used treatment for PCOS women. However, its associations with outcomes of IVF or ICSI-ET in PCOS women remains controversial. So, Yiqing Wu, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China, and colleagues assessed whether metformin is associated with improved outcomes of IVF/ICSI-ET in women with PCOS.
The researchers searched the online databases from database inception to January 31, 2020. It included randomized clinical trials (RCTs) that enrolled with PCOS undergoing infertility treatment with IVF/ICSI-ET and reported at least 1 outcome of IVF/ICSI-ET.
The study included a total of 12 RCTs, which collectively included 1123 women with PCOS undergoing infertility treatment with IVF/ICSI-ET.
Outcomes included ovarian hyperstimulation syndrome (OHSS), clinical pregnancy rate, and live birth rate.
Key findings of the study include:
- The risk of OHSS in women randomized to metformin was lower than in women not randomized to metformin (OR, 0.43), although this difference was not significant for women with PCOS with a body mass index of less than 26 (OR, 0.67).
- There was no significant difference in clinical pregnancy rate (OR, 1.24) or live birth rate (OR, 1.23) in the total population studied.
- In a post hoc analysis among women with a body mass index of 26 or greater, metformin treatment was associated with increased clinical pregnancy rates (OR, 1.71).
"Metformin treatment should be carefully considered for women with PCOS undergoing IVF/ICSI-ET and may be more preferred among women with a BMI of 26 or greater," concluded the authors.
The findings of this study suggest that metformin treatment should be carefully considered for women with polycystic ovarian syndrome undergoing in vitro fertilization and may be more preferred among overweight women with a body mass index of 26 or greater.
The study, "Association of Metformin With Pregnancy Outcomes in Women With Polycystic Ovarian Syndrome Undergoing In Vitro Fertilization: A Systematic Review and Meta-analysis," is published in the journal JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2020.11995
