Metformin on Polycystic Ovary Syndrome: a Pilot Study

Polycystic ovary syndrome (PCOS) affects 6–10% of women of reproductive age and is a common cause of infertility [1]. Its clinical manifestations can include menstrual irregularities, signs of androgen excess, and obesity [1]. Trials focusing on pregnancy as an outcome may place greater emphasis on anovulation as the identifying symptom, rather than the presence of polycystic ovaries or clinical hyperandrogenism [2]. Women with chronic hyperandrogenism and irregular menstrual cycles and/or polycystic ovaries appear to be at substantially greater risk of insulin resistance than those with hyperandrogenism and regular cycles [3,4]. It is, therefore, essential that studies into the metabolic features of PCOS should stratify affected women according to ovulatory function (i.e. chronic oligomenorrhea/amenorrhea versus regular cycles). It has been shown that a proportion of PCOS patients do not demonstrate any overt abnormality in circulating androgens [1,5,6]. The optimal management of PCOS is uncertain, and treatment focuses on amelioration of the clinical features. The aim of treatment is to restore ovulatory cycles so that pregnancy can be achieved. Clinical studies have shown that metformin (500 mg three times per day or 850 mg twice daily, with meals) administered to women with PCOS increases the frequency of spontaneous ovulation, menstrual regularity, and ovulatory response to clomiphene [7,8]. However, the long-term use of insulin-sensitizing agents needed to prevent the potential complications of PCOS cannot be recommended because of a lack of evidence regarding their safety and efficacy [9]. Recent animal investigations have established a role for calcium in oocyte activation and maturation, resulting in the resumption and progression THE EFFECTS OF CALCIUM-VITAMIN D AND METFORMIN ON POLYCYSTIC OVARY SYNDROME: A PILOT STUDY