Kjøtrød Sigrun B, Sunde Arne, von Düring Vidar, Carlsen Sven M
Department of Obstetrics and Gynaecology, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway.
Fertil Steril. 2009 Feb;91(2):500-8. doi: 10.1016/j.fertnstert.2007.11.069. Epub 2008 Mar 4.
To determine the effects of metformin treatment on serum androgen levels ahead of and during the IVF cycle in infertile polycystic ovary syndrome (PCOS) women.
A prospective, double-blind, placebo-controlled study.
Single-center, university IVF clinic.
Sixty-three PCOS women.
INTERVENTION(S): Treatment with metformin 2,000 mg/day or identical placebo tablets for at least 14 weeks before and then during IVF treatment, ending on the day of hCG injection.
MAIN OUTCOME MEASURE(S): Serum levels of dehydroepiandrosterone, dehydroepiandrosterone sulphate (DHEAS), androstenedione, free testosterone index (FTI), dihydrotestosterone, and the androgen metabolite 5alpha-androstane-3alpha, 17beta-diol-glucuronide were measured at five time points ending on the day of ovum collection.
RESULT(S): During metformin pretreatment DHEAS increased, wheres other androgens were unaffected. During the IVF procedure androgens were unaffected by metformin treatment. Within 36 hours after the study medication was withdrawn the levels of androstenedione and FTI increased in the metformin group, whereas DHEAS decreased.
CONCLUSION(S): In infertile PCOS women metformin treatment increased DHEAS levels. During the IVF cycle androgen levels were unaffected by metformin, whereas there was a "rebound" effect when stopping metformin treatment.
确定二甲双胍治疗对多囊卵巢综合征（PCOS）不孕女性体外受精（IVF）周期之前及期间血清雄激素水平的影响。
一项前瞻性、双盲、安慰剂对照研究。
单中心大学IVF诊所。
63名PCOS女性。
在IVF治疗前至少14周以及治疗期间，给予2000毫克/天的二甲双胍或相同的安慰剂片，至人绒毛膜促性腺激素（hCG）注射日结束。
在取卵日结束的五个时间点测量血清脱氢表雄酮、硫酸脱氢表雄酮（DHEAS）、雄烯二酮、游离睾酮指数（FTI）、双氢睾酮以及雄激素代谢产物5α-雄烷-3α,17β-二醇-葡萄糖醛酸苷的水平。
在二甲双胍预处理期间，DHEAS升高，而其他雄激素未受影响。在IVF过程中，二甲双胍治疗对雄激素无影响。在停用研究药物后36小时内，二甲双胍组的雄烯二酮和FTI水平升高，而DHEAS降低。
在PCOS不孕女性中，二甲双胍治疗可提高DHEAS水平。在IVF周期中，二甲双胍对雄激素水平无影响，而停用二甲双胍治疗时有“反弹”效应。
