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Research Article

Effects of metformin in reducing insulin resistance and reversing gonadotrophin levels (LH, FSH) followed by ovulation induction in infertile women with polycystic ovarian syndrome

Authors:

Parul Jahan,

Medical College for Women and Hospital, Dhaka, BD
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Abu SM Giasuddin ,

Medical College for Women and Hospital, Dhaka, BD
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Abu MM Haq

Medical College for Women and Hospital, Dhaka, BD
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Abstract

Objectives: To evaluate the effectiveness of metformin in reducing insulin resistance, reversing the LH:FSH and followed by ovulation induction in infertile Bangladeshi patients with polycystic ovarian syndrome (PCOS).

Materials and methods: Cases were infertile patients with PCOS (n=35, age range – 18-35 years/Mean, age±SD – 25.68±3.81 years, infertility – 1.5-10.0 years, Mean±SD – 4.12± 1.21 years) obtained from OG-OPD at MCW&H, Dhaka. Infertile Bangladeshi couples without PCOS (n=30) were included as controls. After fasting blood samples were collected at inclusion (PCOS-Iº), metformin was prescribed (850 mg bd) and they were followed up after 2 months when fasting blood samples were taken again (PCOS-IIº). Blood levels of glucose, insulin, insulin resistance (HOMA-IR), LH, FSH and LH:FSH were measured by standard laboratory methods. The patients were then given letrozole (aromatase inhibitor) (5 mg daily for 5 days from 2nd day of cycle) and were continued for 3 consecutive cycles for pregnancy.

Results: Raised levels of insulin and HOMA-IR in PCOS-Iº were reduced significantly by metformin treatment (PCOS-Iº vs PCOS-IIº P<0.001), but not to the control levels. Similarly, the elevated levels of LH, FSH and LH:FSH were lowered significantly (PCOS-Iº vs PCOS-IIº P<0.001), but again not to the full extent of control levels. Only 12/35, i.e. 34.28% patients became pregnant after 3 months of letrozole treatment. Of the 12 (34.28%) pregnancy positive patients, 5 (14.28%) and 7 (20%) were obese and non-obese respectively which was not statistically different (P>0.25).

Conclusions: In 34.28% of the PCOS patients, insulin resistance and LH:FSH could be corrected and a successful conception was achieved by letrozole. In rest of the cases some other factors may be involved which could not be addressed by letrozole alone.

Key words: PCOS; metformin; insulin resistance; FSH; LH.

DOI: http://dx.doi.org/10.4038/sljog.v33i3.4017  

Sri Lanka Journal of Obstetrics and Gynaecology 2011; 33: 98-103

How to Cite: Jahan, P., Giasuddin, A.S. & Haq, A.M., (2012). Effects of metformin in reducing insulin resistance and reversing gonadotrophin levels (LH, FSH) followed by ovulation induction in infertile women with polycystic ovarian syndrome. Sri Lanka Journal of Obstetrics and Gynaecology. 33(3), pp.98–103. DOI: http://doi.org/10.4038/sljog.v33i3.4017
Published on 23 Jan 2012.
Peer Reviewed

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