The Utility of Metformin Therapy in Reproductive-Aged Women with Polycystic Ovary Syndrome (PCOS)

    N. Nathan, Shannon D. Sullivan
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    TLDR Metformin helps regulate menstrual cycles, induce ovulation, and improve pregnancy outcomes in women with PCOS.
    The document from 2014 reviews the benefits of metformin therapy in reproductive-aged women with Polycystic Ovary Syndrome (PCOS). Metformin, primarily used to treat Type 2 Diabetes Mellitus (T2DM), has been found to be effective in regulating menstrual cycles, inducing ovulation, and improving pregnancy rates and outcomes in women with PCOS. It has a 46% ovulation rate compared to 24% with placebo and may reduce the risk of ovarian hyperstimulation syndrome. While metformin is not as effective as clomiphene citrate alone for ovulation induction, it enhances the ovulatory response when combined with clomiphene or letrozole. Metformin use during pregnancy is associated with a protective effect against major fetal malformations and may reduce early miscarriage rates. It also shows potential in reducing hypertensive disorders of pregnancy. However, there is conflicting data on its benefits in preventing preeclampsia, gestational diabetes, or preterm delivery, and further research is needed to clarify its role in PCOS treatment across different phenotypes and during pregnancy.
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