Abstract
Metformin is an oral biguanide currently used as antihyperglycemic agent to treat type 2 diabetes mellitus (DM) and the insulin-sensitising drug (ISD) most extensively studied in the treatment of infertility in women with polycystic ovary syndrome (PCOS). Even if knowledge regarding its effects and regimens of administration in PCOS patients is still incomplete, clinical data have suggest its efficacy in improving ovulation rate and pregnancy rate in young women with PCOS and anovulatory infertility. Metformin plus clomiphene citrate (CC) co-administration improves fertility outcomes in infertile CC-resistant patients with PCOS with no other infertility factors. In patients who received gonadotrophins as treatment for anovulation, metformin addition reduces the duration of the treatment and the doses required and increases the rate of mono-ovulations, reducing the risk of cancelled cycles. On the other hand, in infertile patients with PCOS treated with gonadotrophins for in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles, metformin reduces the incidence of ovarian hyperstimulation syndrome.
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