Preconception and first-trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis
Abstract
OBJECTIVE: This study aimed to explore the effects of preconception and first-trimester metformin use on pregnancy outcomes in women with polycystic ovary syndrome.
DATA SOURCES: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from database inception to August 1, 2024.
STUDY ELIGIBILITY CRITERIA: Randomized controlled trials of metformin started before conception and continued at least until a positive pregnancy test compared with either placebo or no treatment in women with polycystic ovary syndrome were included.
METHODS: A systematic review and meta-analysis was conducted. Pooled odds ratios with 95% confidence intervals were calculated for the following key outcomes: miscarriage (primary) and clinical pregnancy and live birth (secondary). The studies were assessed for quality using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Grading of Recommendations, Assessment, Development, and Evaluation approach. Indirect comparisons were performed for all key outcomes on the timing of metformin treatment using the Bucher technique.
RESULTS: A total of 12 trustworthy studies (involving 1708 women) were included in the meta-analysis, all of which were graded low to moderate quality. Women who received preconception metformin that was continued throughout the first trimester of pregnancy showed higher clinical pregnancy rates (odds ratio, 1.57 [95% confidence interval, 1.11-2.23]), a possible reduction in miscarriage (odds…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,708 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.