Abstract
Metformin (MF), a first-line drug to treat type 2 diabetes mellitus (T2DM), alone and in combination with other drugs, restores the ovarian function in women with polycystic ovary syndrome (PCOS) and improves fetal development, pregnancy outcomes and offspring health in gestational diabetes mellitus (GDM) and T2DM. MF treatment is demonstrated to improve the efficiency of in vitro fertilization and is considered a supplementary drug in assisted reproductive technologies. MF administration shows positive effect on steroidogenesis and spermatogenesis in men with metabolic disorders, thus MF treatment indicates prospective use for improvement of male reproductive functions and fertility. MF lacks teratogenic effects and has positive health effect in newborns. The review is focused on use of MF therapy for restoration of female and male reproductive functions and improvement of pregnancy outcomes in metabolic and endocrine disorders. The mechanisms of MF action are discussed, including normalization of metabolic and hormonal status in PCOS, GDM, T2DM and metabolic syndrome and restoration of functional activity and hormonal regulation of the gonadal axis.
Highlights
Metformin (1,1-dimethyl biguanide hydrochloride) (MF), an orally administered biguanide, is a first-line drug for the treatment of type 2 diabetes mellitus (T2DM)
The data presented in the review convincingly prove that MF has an improving effect on reproductive functions both in women with polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM) and T2DM, and in men with
The effectiveness of MF therapy is due to a large number of different factors that must be taken into account when choosing this therapy and when developing a strategy for using MF
Summary
Metformin (1,1-dimethyl biguanide hydrochloride) (MF), an orally administered biguanide, is a first-line drug for the treatment of type 2 diabetes mellitus (T2DM). It reduces the adipose tissue mass and increases the tissue sensitivity to insulin, thereby reducing hyperglycemia, normalizing carbohydrate and lipid metabolism and preventing inflammation and oxidative stress in the tissues [1,2]. There is a large body of evidence for the effectiveness of MF therapy in restoration of reproductive functions and fertility in women with polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM) and T2DM, as well as to improve the effectiveness of the assisted reproductive technologies (ART), such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Pharmaceuticals 2021, 14, 42 only a brief description of the molecular mechanisms of MF action in target cells; these mechanisms are the focus of other review articles [17,18,19,20,21,22,23,24]
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