Christianson Mindy S, Wu Harold, Zhao Yulian, Yemini Matan, Leong Milton, Shoham Zeev
Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,
J Assist Reprod Genet. 2015 Mar;32(3):401-6. doi: 10.1007/s10815-014-0414-x. Epub 2015 Jan 30.
To identify trends regarding therapeutic approaches to metformin administration in patients undergoing in vitro fertilization (IVF) treatment worldwide.
A retrospective evaluation utilizing the results of a web-based survey, IVFWorldwide ( www.IVF-worldwide.com/ ), was performed.
Responses from 101 centers performing a total of 50,800 annual IVF cycles was performed. Of these cycles, 10.4% (n = 5,260) reported metformin use during IVF cycles. Indications for metformin use in IVF cycles included polycystic ovary syndrome (PCOS) patients who were habitual abortions (67%), had prior poor egg quality (61%), had high serum insulin levels (56%). Less reported was PCOS with obesity/anvoulation (29%), PCOS with multiple manifestations (23%) and glucose intolerance and insulin resistance (23%). Over half of cycles (54%) treated patients with metformin up to 3 months prior to starting IVF. A majority (82%) of IVF cycles utilized 1500-2000 mg/day of metformin. A nearly equal percentage of centers continued metformin up to a positive β-HCG test (35%) or to 12 weeks gestation (33%). 70% of IVF cycles reported increased pregnancy rates and decreased miscarriage rates due to the use of metformin. 75% reported the data in the literature is not sufficient for reaching a definitive conclusion concerning metformin treatment in patients undergoing IVF.
While metformin is used worldwide as an adjunct to standard IVF protocols, there is much variation in its use and the majority of centers report lack of evidence supporting its use.
确定全球范围内接受体外受精（IVF）治疗的患者使用二甲双胍的治疗方法趋势。
利用基于网络的调查IVFWorldwide（www.IVF-worldwide.com/）的结果进行回顾性评估。
对101个中心进行了调查，这些中心每年共进行50800个IVF周期。在这些周期中，10.4%（n = 5260）报告在IVF周期中使用了二甲双胍。IVF周期中使用二甲双胍的指征包括习惯性流产的多囊卵巢综合征（PCOS）患者（67%）、既往卵子质量差的患者（61%）、血清胰岛素水平高的患者（56%）。较少报告的指征是伴有肥胖/无排卵的PCOS（29%）、具有多种表现的PCOS（23%）以及葡萄糖不耐受和胰岛素抵抗（23%）。超过一半的周期（54%）在开始IVF前3个月内使用二甲双胍治疗患者。大多数（82%）的IVF周期使用1500 - 2000毫克/天的二甲双胍。几乎相同比例的中心在β-HCG检测呈阳性（35%）或妊娠12周时（33%）继续使用二甲双胍。70%的IVF周期报告使用二甲双胍后妊娠率增加且流产率降低。75%报告文献中的数据不足以就接受IVF治疗的患者使用二甲双胍得出明确结论。
虽然二甲双胍在全球范围内被用作标准IVF方案的辅助药物，但其使用存在很大差异，且大多数中心报告缺乏支持其使用的证据。
