Role Of Metformin For Ovulation Induction In Infertile Patients With Polycystic Ovary Syndrome (PCOS)

Publication Date: September 1, 2017
Last Updated: March 14, 2022

Summary

There is good evidence that metformin alone vs placebo increases the ovulation rate in women with PCOS. (, A)
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Recommendations

Metformin alone should not be used as first-line therapy for ovulation induction in women with PCOS, since ovulation induction agents such as CC or letrozole are more effective. CC alone or letrozole alone are reasonable first-line agents for ovulation in women with PCOS. Combination therapy with CC may be beneficial in women who are resistant to CC alone. While metformin alone is not likely to increase live-birth rate in women seeking pregnancy in the short term, utilizing metformin in individualized cases of PCOS with the goal of improving ovulation rates over the long term may be of benefit. In the context of increased ovulation rate and overall improved insulin resistance on metformin, the subsequent addition of other ovulation-inducing agents may be beneficial in increasing pregnancy rates, although there is insufficient evidence of an increase in live-birth rates. These data suggest that individualization of treatment may be warranted, particularly in younger women with PCOS. Additional large, adequately powered randomized trials are needed in carefully defined populations of women with various forms of PCOS (i.e., phenotype specified) to determine in whom the use of metformin may be of benefit.
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Overview

Title

Role Of Metformin For Ovulation Induction In Infertile Patients With Polycystic Ovary Syndrome (PCOS)

Authoring Organization