 Conception rates among 600 infertile women with PCOS were higher with use of clomid
Posted on Mon, Mar. 12, 2007
Dr. H | Pill for diabetes is used to treat infertility
By Mitchell Hecht
McCLATCHY TRIBUNE NEWS SERVICE
Question: I have been trying for two years to become pregnant. After ruling out fertility issues with my husband, my obstetrician believes that I have polycystic ovarian syndrome, which is making it hard for me to get pregnant. She put me on metformin, which I understand is a diabetic pill. If I'm not a diabetic, how will that help me?
A: Polycystic ovarian syndrome (PCOS) is the most common cause of female infertility, affecting up to 10 percent of all women of child-bearing age. It's causing you not to ovulate because of an overproduction of androgens (male sex hormones) and estrogen. Your hormones are not in the right balance for you to conceive a child.
These hormonal changes also cause acne, insulin resistance/diabetes, excess facial and body hair, and obesity. What we know is that metformin will lower your presumably high insulin level so that even if you're not a diabetic, insulin levels will fall. Metformin's benefit to you is that male sex hormone levels will fall and you'll have an improved balance between your female and male hormones. That should help your chances of successful pregnancy by increasing the chance of ovulation.
With that said, a recent study published in the New England Journal of Medicine found that conception rates among 600 infertile women with PCOS were higher with the use of the fertility drug clomiphene (induces egg release; associated with multiple births) than with metformin (30 percent versus 12 percent). The rates of live births were also higher in the clomiphene-treated group (23 percent) than in the metformin-treated group (7 percent). This study did not look at the success rates with the use of both clomiphene and metformin, but I suspect that birth rates would be even higher.
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Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076. Due to the large volume of mail received, personal replies are not possible.
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