Biomaterial Database

The use of metformin in the management of polycystic ovary syndrome and associated anovulatory infertility: the current evidence. 2009

L Leeman, and U Acharya

Peninsula Medical School, Plymouth, UK. lucy.leeman@doctors.org.uk

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.

UI	MeSH Term	Description	Entries
D007004	Hypoglycemic Agents	Substances which lower blood glucose levels.	Antidiabetic,Antidiabetic Agent,Antidiabetic Drug,Antidiabetics,Antihyperglycemic,Antihyperglycemic Agent,Hypoglycemic,Hypoglycemic Agent,Hypoglycemic Drug,Antidiabetic Agents,Antidiabetic Drugs,Antihyperglycemic Agents,Antihyperglycemics,Hypoglycemic Drugs,Hypoglycemic Effect,Hypoglycemic Effects,Hypoglycemics,Agent, Antidiabetic,Agent, Antihyperglycemic,Agent, Hypoglycemic,Agents, Antidiabetic,Agents, Antihyperglycemic,Agents, Hypoglycemic,Drug, Antidiabetic,Drug, Hypoglycemic,Drugs, Antidiabetic,Drugs, Hypoglycemic,Effect, Hypoglycemic,Effects, Hypoglycemic
D007247	Infertility, Female	Diminished or absent ability of a female to achieve conception.	Sterility, Female,Sterility, Postpartum,Sub-Fertility, Female,Subfertility, Female,Female Infertility,Female Sterility,Female Sub-Fertility,Female Subfertility,Postpartum Sterility,Sub Fertility, Female
D008687	Metformin	A biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. Metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (From Martindale, The Extra Pharmacopoeia, 30th ed, p289)	Dimethylguanylguanidine,Dimethylbiguanidine,Glucophage,Metformin HCl,Metformin Hydrochloride,HCl, Metformin,Hydrochloride, Metformin
D011085	Polycystic Ovary Syndrome	A complex disorder characterized by infertility, HIRSUTISM; OBESITY; and various menstrual disturbances such as OLIGOMENORRHEA; AMENORRHEA; ANOVULATION. Polycystic ovary syndrome is usually associated with bilateral enlarged ovaries studded with atretic follicles, not with cysts. The term, polycystic ovary, is misleading.	Stein-Leventhal Syndrome,Polycystic Ovarian Syndrome,Polycystic Ovary Syndrome 1,Sclerocystic Ovarian Degeneration,Sclerocystic Ovaries,Sclerocystic Ovary Syndrome,Ovarian Degeneration, Sclerocystic,Ovarian Syndrome, Polycystic,Ovary Syndrome, Polycystic,Ovary, Sclerocystic,Sclerocystic Ovary,Stein Leventhal Syndrome,Syndrome, Polycystic Ovary,Syndrome, Stein-Leventhal
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000858	Anovulation	Suspension or cessation of OVULATION in animals or humans with follicle-containing ovaries (OVARIAN FOLLICLE). Depending on the etiology, OVULATION may be induced with appropriate therapy.	Anovulations
D018579	Patient Selection	Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.	Patient Recruitment,Research Subject Recruitment,Selection Criteria,Research Subject Selection,Selection for Treatment,Selection of Research Volunteers,Selection of Subjects,Criteria, Selection,Recruitment, Patient,Recruitment, Research Subject,Recruitments, Research Subject,Research Subject Recruitments,Research Subject Selections,Research Volunteers Selection,Research Volunteers Selections,Selection for Treatments,Selection, Patient,Selection, Research Subject,Selections, Research Subject,Subject Recruitment, Research,Subject Recruitments, Research,Subject Selection, Research,Subject Selections, Research,Subjects Selection,Subjects Selections,Treatment, Selection for,Treatments, Selection for,Volunteers Selection, Research