Washington Center for Reproductive Medicine

Fertility Drugs

Glucophage (Metformin)

Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women. It is characterized by elevated levels of androgens and ovaries with numerous cystic follicles. Androgens are male hormones, such as testosterone, that cause the conditions seen in the PCOS patient such as anovulation, excess body hair, a classic pear shaped body appearance, and being overweight (sometimes).

Most patients with PCOS have elevated insulin levels a, condition know as hyperinsulinemia. The body's cells do not correctly measure the levels of circulating insulin and consequently overproduce it. Hyperinsulinemia leads to excess androgen and LH production by the ovaries. (Physiology)

Metformin (Glucophage) is an "insulin sensitizing agent" used in the treatment of diabetes. In other words, it helps correct the cells "misreading" of insulin levels and reverses insulin resistance.

Once the insulin resistance is corrected in the PCOS patient, the levels of androgens and LH decrease and normal ovulation can naturally resume. Metformin is often effective as sole therapy in inducing ovulation in anovulatory PCOS patients.

Some reproductive endocrinologists are recommending long-term therapy with Metformin in PCOS patients.  Continued administration can reduce other health risks associated with hyperinsulinemia such as cardiovascular disease.

If ovulation does not occur with Metformin alone, Clomid or FSH can be added. The major side effects include nausea and diarrhea.

















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