Text for Appt 949-996-9522  |  Can I afford treatment? Check out our Financial Guide

How Does Metformin Help PCOS?

Should I Take Metformin for PCOS?

PCOS, or Polycystic Ovarian Syndrome, is a condition that often consists of menstrual irregularities (typically absent or sporadic menses), signs of increased androgens (hair growth, acne or hair loss) and the presence of multiple ‘cysts’ on an ovary. It’s common for women who seek treatment at a fertility clinic to have long or absent cycles secondary to delayed or lack of ovulation.

 

The critical part of trying to conceive is timing intercourse (or an insemination) near the time of ovulation. Obviously, if an individual is not ovulating at regular intervals—or at very delayed intervals—it can lower their chances of conceiving significantly.

How Does Metformin Help With PCOS?

The underlying mechanism causing menstrual irregularities for those with PCOS stems from the presence of an imbalance of androgens (i.e. testosterone). Although androgens are critical in the production of estrogen (a pivotal hormone involved in the menstrual cycle), an overproduction of androgens can result in an imbalance making the ovary unable to ovulate at regular intervals. Studies have shown that there is a direct correlation between insulin levels and androgen levels, indicating that elevated insulin levels result in higher levels of androgens. It is unclear which one comes first (elevated androgens leading to elevated insulin vs elevated insulin leading to elevated androgens) but we do know they are tied together, which is why Metformin was first introduced as a way to help regulate the menstrual cycle in women with PCOS.

Randomized trials have shown that in patients who aren’t ovulating regularly and have PCOS, the addition of Metformin (when compared to a placebo) helped initiate ovulation, increasing pregnancy rates. Although promising, the findings showed that it was Metformin in conjunction with diet and lifestyle changes that were the cause of these improved outcomes. 

Taking Metformin, in addition to Clomid, for ovulation induction has not been clearly shown to significantly improveme outcomes, but there might be some patients who could still benefit from it.

After a careful discussion about the risks, benefits and possible side effects with your doctor, a thoughtful decision about whether Metformin—or any other treatment—is the appropriate next step for you and your fertility journey is a good idea when PCOS is part of your family-building journey.

Author
Nidhee Sachdev, MD, FAOCG Dr. Nidhee Sachdev Nidhee Sachdev, MD has trained among the most prestigious and diverse medical programs in the country, including fellowship training in reproductive endocrinology and infertility at the prestigious New York University (NYU) Langone Fertility Center in New York City where she conducted research on preimplantation genetic screening (PGS) and the University of Chicago Medical Center, where she earned the academic distinction of chief resident in obstetrics and gynecology, and trained under a top recurrent pregnancy loss expert. Dr. Sachdev is passionate about providing individualized, collaborative patient care. She started her medical career right here in Orange County, earning her Doctor of Medicine at the University of California, Irvine, School of Medicine.

You Might Also Enjoy...

Man and Woman sitting with financial advisor in front of computer

Navigating Your Financial Options During Fertility Treatment

At OC Fertility + OC Biogenix, we know that financial constraints should not stand in the way of your dream to build a family. That’s why we are committed to helping you explore various financial assistance programs and options for your fertility journey.

5 Things You Should Know Before Starting IVF

In Vitro Fertilization, also known as IVF, is often a great solution for those trying to conceive when faced with infertility, but what exactly does IVF entail? Before diving into the process, it’s important to be well-informed with these 5 things.
A textbook image of the female reproductive system being looked down upon by a person with light hair

What is a Uterine Cavity Evaluation?

A uterine cavity evaluation is an important part of the workup for anyone looking to get pregnant in the near future (for those interested in freezing eggs or embryos for later use, this part of the evaluation can often be deferred).