Zeba Munzar, Anjum Ilahi, Mansur E.
To study the role of metformin on outcomes of pregnancy in patients with polycystic ovarian syndrome.
Isra Med J Jan ;6(4):280-4.

OBJECTIVES: To evaluate the effects of Metformin on outcomes of pregnancy in patients of polycystic ovarian syndrome who conceived on Metformin and then continued it till they delivered, compared to patients where use of metformin was stopped on conception. STUDY DESIGN: This open label randomized study was conducted from October 2010 to October 2012 at the outpatients department of Maroof International Hospital, Islamabad PLACE AND DURATION: 46 patients with polycystic ovarian syndrome who conceived on Metformin (both with and without the help of ovulation inducing agents) were included in the study. Out of these 23 patients discontinued the use (of Metformin) and remaining 23 never stopped using Metformin throughout pregnancy, both these groups were compared to each other in their outcomes. METHODOLOGY: Forty six patients having polycystic ovarian syndrome and infertility were treated with Metformin1gm/day with or without other ovulation induction agents (Clomiphene and injections of Human Menopausal Gonadotropins). Twenty three patients were continued with Metformin 1gm/day throughout pregnancy (group A), and in the second group consisting of twenty three patients(group B) Metformin was discontinued after they conceived. The were first trimester abortions, preterm delivery, Live birth rate, Birth weight, gestational diabetes and fetal anamolies. RESULTS: The incidence of first trimester abortions in group B patients of polycystic ovarian syndrome was 34.7% as compared to group A where the incidence was 4.3% (where Metformin was continued throughout pregnancy).The incidence of gestational diabetes was 8.6% in group A (when Metformin was continued) and 26 % in group B (when Metformin was not continued). There were no fetal anomalies in the women receiving Metfromin during pregnancy. CONCLUSION: Metformin reduces the incidence of first trimester abortions gestational diabetes and impaired glucose tolerance, when the drug was continued throughout pregnancy in subjects with polycystic ovarian syndrome. In addition no adverse effects on the mother or fetus were seen.

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