What is Metformin and why it is used in fertility treatment?

Metformin is an insulin-sensitising medicine that helps in reducing the blood sugar levels and also to treat type 2 diabetes.

Polycystic Ovarian Syndrome (PCOS) is a common cause of infertility in women, and this drug is prescribed to regulate menstrual cycles in PCO patients and increase the chances of pregnancy in them. Obese women diagnosed with PCOS are usually  hyperinsulinemic, that is, they have increased levels of insulin and androgens (male hormones) in their body. Metformin helps to decrease the insulin resistance in PCOS patients.

Metformin may also decrease the risk of miscarriage associated with PCOS. Metformin makes the body cells sensitive to insulin. It also helps to diminish the excess production of androgen by the ovaries to a great extent. Metformin is used as a hormone balancing drug to help resume the ovulation process in some PCOS women. Sometimes, fertility specialists prescribe Metformin along with Ovulation Induction drugs like Clomiphene or Letoval and Follicle Stimulating Hormone (FSH) for inducing ovulation.

How Metformin Helps

Metformin has numerous actions on the body and the main is the suppression of the production of endogenous glucose by the liver. Metformin keeps the insulin production in the body at bay and improves its effectiveness.

Uses of Metformin

Doctors find the use of metformin in fertility treatment effective because it helps in the following way:

• Sensitises insulin receptor to the available Insulin.
• Induce Ovulation: Menstrual cycles become regular with Metformin administration and ovulation is induced as a result in some PCOS patients. But doctors prescribe this drug only to insulin-resistant women with PCOS, and not all diagnosed with PCOS.
• Improve Pregnancy Rate: Doctors accept that a combination of Metformin with other fertility drugs improves the pregnancy rates. Injectable gonadotropins combined with Metformin can boost the birth rate up to 32-60% in women.
• Reduced Risk for Ovarian Hyperstimulation Syndrome: Administration of fertility drugs increases the risk of Ovarian Hyperstimulation Syndrome (OHSS), especially during IVF/ICSI treatment. And women having PCOS are at greater risk of developing OHSS. According to studies, it is found that Metformin can reduce the risk of OHSS while taking IVF/ICSI treatment.
• Repeated Miscarriage: Women having PCOS experience more number of miscarriages than others. According to researchers, Metformin might reduce the risk of miscarriage in women diagnosed with Obese PCOS.
• Weight Reduction: Generally, women with PCOS tend to put on a lot of weight and grow obese. And some studies have found that Metformin may help in the weight reduction process in some of these women so that they have proper ovulation that can lead to a successful pregnancy.

NB:It is advised that Metformin should be taken only when prescribed by a doctor, and follow the dosage suggested by them.