Kumbak Banu, Kahraman Semra
Department of Obstetrics and Gynecology, Yeditepe University, Istanbul, Turkey.
Acta Obstet Gynecol Scand. 2009;88(5):563-8. doi: 10.1080/00016340902835919.
To evaluate the effect of metformin addition during ovarian hyperstimulation on cycle parameters and outcome of in vitro fertilization (IVF) treatment in polycystic ovary syndrome (PCOS) patients with a body mass index (BMI) <28 kg/m(2).
Retrospective review of patients' records.
Istanbul Memorial Hospital Assisted Reproductive Treatment Unit.
A total of 339 non-obese PCOS patients undergoing IVF were evaluated according to the supplementation of metformin.
Cycle parameters and IVF outcomes of 220 patients given metformin were compared to those of 119 patients treated without metformin.
Implantation and pregnancy rates.
Metformin co-treatment led to significantly lower peak E2 levels (3,481 pg/ml vs. 4,192 pg/ml; p <0.0001). However, gonadotropin consumption, stimulation duration, numbers of total and mature oocytes retrieved, fertilization rate, and ratio of grade I embryos developed were similar in both groups. In the metformin administered group, significantly higher implantation (25% vs. 18%; p=0.003) and pregnancy rates (58% vs. 45%; p=0.04) were achieved. Abortion and moderate-severe ovarian hyperstimulation syndrome rates were found to be similar in both groups.
Although metformin use was especially and strongly recommended in obese PCOS cases, its supplementation during IVF in PCOS patients with a BMI <28 kg/m(2) was observed to be beneficial and efficacious.
评估在卵巢过度刺激过程中加用二甲双胍对体重指数（BMI）<28kg/m²的多囊卵巢综合征（PCOS）患者体外受精（IVF）治疗周期参数及结局的影响。
对患者记录进行回顾性分析。
伊斯坦布尔纪念医院辅助生殖治疗科。
共339例接受IVF的非肥胖PCOS患者，根据是否补充二甲双胍进行评估。
将220例使用二甲双胍的患者的周期参数及IVF结局与119例未使用二甲双胍治疗的患者进行比较。
着床率和妊娠率。
联合使用二甲双胍导致E2峰值水平显著降低（3481pg/ml对4192pg/ml；p<0.0001）。然而，两组的促性腺激素用量、刺激持续时间、获取的总卵母细胞数和成熟卵母细胞数、受精率以及发育的I级胚胎比例相似。在使用二甲双胍的组中，着床率（25%对18%；p=0.003）和妊娠率（58%对45%；p=0.04）显著更高。两组的流产率和中重度卵巢过度刺激综合征发生率相似。
尽管特别强烈推荐在肥胖PCOS病例中使用二甲双胍，但观察发现，在BMI<28kg/m²的PCOS患者IVF治疗期间补充二甲双胍是有益且有效的。
