Metformin Use Before Assisted Reproductive Technology and Pregnancy Outcomes in Women With Polycystic Ovary Syndrome: A Nationwide Cohort Study
Abstract
Metformin has been hypothesized to improve ovulation and pregnancy rates in women with polycystic ovary syndrome (PCOS) undergoing assisted reproductive technology (ART). This population-based cohort study assessed pregnancy outcomes associated with metformin use prior to ART in women with PCOS. We included 10,178 women with PCOS undergoing their first fresh embryo transfer cycle under the national health insurance program of South Korea between 2017 and 2021. Women who received metformin for ovulation induction within 12 weeks prior to ovarian stimulation were compared with those who did not receive metformin. ART outcomes included successful oocyte retrieval, embryo transfer, and clinical pregnancy, while pregnancy outcomes included spontaneous abortion, preterm birth, and live birth. Overlap-weighted risk ratios (RR) were calculated for each outcome. Among the study population, 2,149 (21.1%) had used metformin prior to ovarian stimulation, and 8,029 (78.9%) had not. Metformin use did not improve or worsen ART outcomes, with comparable rates of oocyte retrieval (RR: 1.01, 95% confidence interval 1.00-1.02) and clinical pregnancy (RR: 1.05, 1.00-1.11), as well as no increased rates of spontaneous abortion (RR: 1.01, 0.84-1.21), preterm birth (RR: 0.99, 0.84-1.18), or live birth (RR: 1.05, 0.99-1.12). Subgroup analyses suggested modest benefits, including higher clinical pregnancy or live birth rates, among women aged ≥ 35 years, those undergoing a GnRH antagonist protocol,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 10,178 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.