A systematic review and meta-analysis of metformin among patients with polycystic ovary syndrome undergoing assisted reproductive technology procedures.

Abstract

BACKGROUND:

Metformin is used among patients with polycystic ovary syndrome (PCOS), but findings for its effects on outcomes of assisted reproductive technology (ART) have been conflicting.

OBJECTIVES:

To compare ART outcomes among women with PCOS who were and were not given metformin.

SEARCH STRATEGY:

Databases were searched for reports published in English between 2002 and 2013, using combinations of the terms "polycystic ovary syndrome," "PCOS," "insulin-sensitizing," and "metformin."

SELECTION CRITERIA:

Randomized controlled trials of metformin versus placebo among women with PCOS undergoing ART were included if they assessed rates of pregnancy, live birth, spontaneous abortion, multiple pregnancy, and/or ovarian hyperstimulation syndrome (OHSS).

DATA COLLECTION AND ANALYSIS:

Data were extracted from included studies. The Mantel-Haenzel random-effects model was used for meta-analyses.

MAIN RESULTS:

Twelve studies (1516 participants) were included. No significant differences were recorded between metformin and placebo groups for rates of pregnancy (risk ratio [RR] 1.11, 95% CI 0.92-1.33), live birth (RR 1.12, 0.92-1.36), spontaneous abortion (RR 1.00, 0.60-1.67), or multiple pregnancy (RR 0.96, 0.47-1.96). However, OHSS rate was significantly lower among patients who received metformin than among those who received placebo (RR 0.44, 0.26-0.77).

CONCLUSIONS:

Metformin does not improve ART outcomes among patients with PCOS, but does significantly reduce their risk of OHSS.

• Authors: Xiaman Huang, Pin Wang, Reshef Tal, Fang Lv, Yuanyuan Li, Xiaomei Zhang
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 131 Issue 2 Pg. 111-6 (Nov 2015) ISSN: 1879-3479 [Electronic] United States
• PMID: 26304048 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

Chemical References

• Hypoglycemic Agents
• Metformin

Topics

• Abortion, Spontaneous
• Adult
• Female
• Humans
• Hypoglycemic Agents (therapeutic use)
• Live Birth
• Metformin (therapeutic use)
• Ovarian Hyperstimulation Syndrome (etiology)
• Polycystic Ovary Syndrome (complications, drug therapy)
• Pregnancy
• Pregnancy Rate
• Pregnancy, Multiple
• Randomized Controlled Trials as Topic
• Reproductive Techniques, Assisted (statistics & numerical data)
• Risk Factors