American Society for Reproductive Medicine, Birmingham, Alabama.
Fertil Steril. 2017 Sep;108(3):426-441. doi: 10.1016/j.fertnstert.2017.06.026.
Metformin alone compared with placebo increases the ovulation rate in women with polycystic ovary syndrome (PCOS) but should not be used as first-line therapy for anovulation because oral ovulation induction agents such as clomiphene citrate or letrozole alone are much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS. There is fair evidence that metformin alone does not increase rates of miscarriage when stopped at the initiation of pregnancy and insufficient evidence that metformin in combination with other agents used to induce ovulation increases live-birth rates.
二甲双胍单独治疗与安慰剂相比可增加多囊卵巢综合征（PCOS）妇女的排卵率，但不应作为无排卵的一线治疗药物，因为枸橼酸氯米酚或来曲唑等口服排卵诱导剂在增加排卵、妊娠和活产率方面更有效在 PCOS 女性中。有充分证据表明，二甲双胍在妊娠开始时停药不会增加流产率，而联合其他诱导排卵药物使用是否会增加活产率的证据不足。
