A systematic review and meta-analysis of metformin among patients with polycystic ovary syndrome undergoing assisted reproductive technology procedures. Issue 2 (November 2015)

• Record Type: Journal Article
• Authors: Huang, Xiaman; Wang, Pin; Tal, Reshef; Lv, Fang; Li, Yuanyuan; Zhang, Xiaomei
• Is Part Of: International journal of gynaecology and obstetrics. Volume 131:Issue 2(2015:Nov.)
• Page Start: 111
• Page End: 116
• Publication Date: 2015-11
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2015.04.046
• Languages: English
• ISSNs: 0020-7292

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Background</title> <p id="sp0005">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.</p> </sec> <sec> <title id="st0015">Objectives</title> <p id="sp0010">To compare ART outcomes among women with PCOS who were and were not given metformin.</p> </sec> <sec> <title id="st0090">Search strategy</title> <p id="sp0015">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."</p> </sec> <sec> <title id="st0095">Selection criteria</title> <p id="sp0020">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).</p> </sec> <sec> <title id="st0100">Data collection and analysis</title> <p id="sp0025">Data were extracted from included studies. The Mantel-Haenzel random-effects model was used for meta-analyses.</p> </sec> <sec> <title id="st0105">Main results</title> <p id="sp0030">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).</p> </sec> <sec> <title id="st0020">Conclusions</title> <p id="sp0035">Metformin does not improve ART outcomes among patients with PCOS, but does significantly reduce their risk of OHSS.</p> </sec> </abstract>