Polycystic ovarian syndrome is a common hormonal disorder that is poorly understood and clinically characterized by irregular menstrual cycles, lack of regular ovulation, abnormal facial hair growth, infertility, obesity and polycystic ovaries (enlarged, cystic ovaries). This disorder affects approximately 6% of all reproductive age women. Recent evidence indicates that polycystic ovarian syndrome is a disorder characterized by insulin resistance and a compensatory elevated insulin level, which are found in both the overweight and non-overweight woman with the syndrome.
Traditional therapy for women with infertility secondary to polycystic ovarian syndrome has been ovulation induction using clomiphene citrate as a first line agent. Due to this recognition regarding insulin levels and resistance, the use of insulin sensitizing agents such as metformin (GlucophageŽ) for ovulation induction have recently been studied with promising results.
A study recently published in the New England Journal of Medicine, demonstrated that women with polycystic ovarian syndrome had increased rates of ovulation when placed on medications that lower insulin levels. Of the women placed on this medication (metformin), 34% achieved spontaneous ovulation without ovulation induction agents, compared to 4% in the placebo control group. Of those women who did not ovulate on metformin, 90% achieved ovulation with 50 mg of clomiphene citrate, compared with 3 of 26 women (8%) in the placebo group.
Insulin-lowering agents for ovulation induction in women with Polycystic Ovarian Syndrome are an attractive alternative due to their low cost, minimal side effects and decreased risk for multiple pregnancies compared with other agents.
Since the use of metformin for ovulation induction in women with polycystic ovarian syndrome is relatively new, the best method for ovulation induction is yet to be determined. The physicians at Southeastern Fertility Center individualize patient care and your treatment may involve the use of metformin alone or in combination with other medications.
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