Leeman L, Acharya U
Peninsula Medical School, Plymouth, UK.
J Obstet Gynaecol. 2009 Aug;29(6):467-72. doi: 10.1080/01443610902829414.
Women suffering from anovulatory infertility are frequently diagnosed with polycystic ovary syndrome (PCOS), which is a varied condition of ovarian dysfunction characterised by hyperandrogenaemia and abnormal ovarian morphology. PCOS has been associated with insulin resistance, leading to the insulin-sensitising agent, metformin, being investigated as a useful therapy for the reinstatement of normal ovarian function and regular ovulation. While some trials and meta-analyses have produced very positive results with regard to improved ovulation rates in PCOS patients, this trend has not been universal and there has been some criticism of the acceptance of metformin as a first-line agent for PCOS. It is possible that metformin is more effective in certain patients, a hypothesis supported by the heterogeneous nature of the condition. This paper provides an overview of PCOS, reviews relevant literature regarding metformin and PCOS related infertility and discusses patient selection prior to instigating treatment.
患有无排卵性不孕症的女性常被诊断为多囊卵巢综合征（PCOS），这是一种卵巢功能障碍的复杂病症，其特征为高雄激素血症和异常的卵巢形态。PCOS与胰岛素抵抗有关，这使得胰岛素增敏剂二甲双胍被作为恢复正常卵巢功能和规律排卵的有效疗法进行研究。虽然一些试验和荟萃分析在改善PCOS患者排卵率方面取得了非常积极的结果，但这种趋势并不普遍，并且对于将二甲双胍作为PCOS的一线药物存在一些批评。二甲双胍可能在某些患者中更有效，这一假设得到了该病症异质性的支持。本文概述了PCOS，回顾了关于二甲双胍和PCOS相关不孕症的相关文献，并讨论了开始治疗前的患者选择。
