Journal
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
Volume 131, Issue 2, Pages 111-116Publisher
WILEY
DOI: 10.1016/j.ijgo.2015.04.046
Keywords
Assisted reproductive technology; Metformin; Polycystic ovary syndrome; Pregnancy; Systematic review
Categories
Funding
- National Natural Science Foundation of China [81100421]
- Jiangsu Provincial Postgraduate Innovation and Practice project [SJLX_0622]
- Social Development Project in Jiangsu Province [BE2010698, BE2012706]
- Top Six Talent Peaks Program of Jiangsu [2014-WSW-080]
- National Science Foundation of Yangzhou [YZ2014050]
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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 0.92-133), live birth (RR 1.12,0.92-136), 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, 026-0.77). Conclusions: Metformin does not improve ART outcomes among patients with PCOS, but does significantly reduce their risk of OHSS. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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