Metformin has been used in women with polycystic ovarian syndrome (PCOS) for many years to regulate their menstrual cycle. It has been thought to work by reducing the body’s sugar levels thereby reducing other related hormones such as insulin and androgens. This then leads to changes in the body that ultimately results in the menstrual cycle becoming normal in many women. Some scientists have advocated the use of metformin in women with PCOS who are undergoing treatment with in vitro fertilization (IVF) in an attempt to improve egg quality and possibly success rates. The research data regarding this are mixed and not universally accepted for IVF.
There are many women with PCOS who have also been diagnosed with diminished ovarian reserves (DOR). DOR implies a reduction in the women’s egg quality and thus possibly lead to reduced pregnancy rates with IVF.
A recent paper was published in a respected medical journal by Palomba and colleagues who studied the use of metformin in women diagnosed with PCOS and DOR undergoing IVF. These women were divided into two groups: group 1 received metformin along with their fertility medications and group 2 received placebo (sugar pill) and the fertility medications. These researchers found that women in group 1 required a significantly higher dose of fertility medications during their IVF cycle. Also, women in group 1 had a more than twice the risk of having their IVF cycle cancelled compared to group 2. As a matter of fact, the researchers were so alarmed by these results that the study was terminated prematurely. Based on this research, the use of metformin in women with PCOS and DOR undergoing IVF should not be advised.