Shpakov Alexander O
I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry of Russian Academy of Sciences, 194223 Saint Petersburg, Russia.
Pharmaceuticals (Basel). 2021 Jan 8;14(1):42. doi: 10.3390/ph14010042.
Metformin (MF), a first-line drug to treat type 2 diabetes mellitus (T2DM), alone and in combination with other drugs, restores the ovarian function in women with polycystic ovary syndrome (PCOS) and improves fetal development, pregnancy outcomes and offspring health in gestational diabetes mellitus (GDM) and T2DM. MF treatment is demonstrated to improve the efficiency of in vitro fertilization and is considered a supplementary drug in assisted reproductive technologies. MF administration shows positive effect on steroidogenesis and spermatogenesis in men with metabolic disorders, thus MF treatment indicates prospective use for improvement of male reproductive functions and fertility. MF lacks teratogenic effects and has positive health effect in newborns. The review is focused on use of MF therapy for restoration of female and male reproductive functions and improvement of pregnancy outcomes in metabolic and endocrine disorders. The mechanisms of MF action are discussed, including normalization of metabolic and hormonal status in PCOS, GDM, T2DM and metabolic syndrome and restoration of functional activity and hormonal regulation of the gonadal axis.
二甲双胍（MF）是治疗2型糖尿病（T2DM）的一线药物，单独使用或与其他药物联合使用时，可恢复多囊卵巢综合征（PCOS）女性的卵巢功能，并改善妊娠期糖尿病（GDM）和T2DM患者的胎儿发育、妊娠结局及子代健康。已证实MF治疗可提高体外受精效率，被视为辅助生殖技术中的一种补充药物。MF给药对患有代谢紊乱的男性的类固醇生成和精子发生有积极作用，因此MF治疗显示出改善男性生殖功能和生育能力的潜在用途。MF没有致畸作用，对新生儿有积极的健康影响。本综述重点关注MF疗法在恢复男女两性生殖功能以及改善代谢和内分泌紊乱患者妊娠结局方面的应用。文中讨论了MF的作用机制，包括PCOS、GDM、T2DM和代谢综合征中代谢和激素状态的正常化，以及性腺轴功能活性和激素调节的恢复。
