Correlation between the effect of Metformin Drug, Pregnancy Outcome, and Homo-IR in PCOS Women Undergo ICSI Technique

Rana R. AL-Saadi; Amal Abdulwahid Mohammed; Ban Thabit Saeed; Abbas AbdulWahhab Jumaah Al-Salihi

Rana R. AL-Saadi Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Nahrain University, Kadhimiya, Baghdad, Iraq.
Amal Abdulwahid Mohammed Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Nahrain University, Kadhimiya, Baghdad, Iraq.
Ban Thabit Saeed Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Nahrain University, Kadhimiya, Baghdad, Iraq.
Abbas AbdulWahhab Jumaah Al-Salihi Department of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Nahrain University, Kadhimiya, Baghdad, Iraq.

Keywords: ICSI, PCOS, Metformin, HOMA-IR

Abstract

Metformin has already demonstrated its aptness in weight loss among obese women, whereas the existence of available evidence concerning the improvement in insulin resistance in PCOS women remains cloudy. The study is geared towards finding out the effect of metformin in conjunction with fresh ICSI in Iraqi women with PCOS as a potential treatment for infertility. Of the 41 referred women, most of them were diagnosed with polycystic ovary syndrome before being subjected to tests to suit the infertility clinic's facility. The study analysis was carried out using a randomized control referring to the use of forty-eight-infertile-patients with PCOS randomly assigned into two groups and before the ovarian stimulation part of the ICSI program received 500 mg of metformin treatment twice a day for some two months prior and during the ICSI cycle. A group consisting of twenty women who partaken of placebos for infertility served as the control. The basal hormonal levels are assessed at the time of the ICSI cycle: HOMA-IR was measured at the day of oocyte pickup. The main endpoints relate to the number of oocytes recovered, embryo quality, and clinical pregnancy occurrence. The number of retrieved oocytes, number of mature oocytes, peak estradiol levels, and stimulation days were similar in both groups. The study has shown that HOMA-IR is insignificantly lower in pregnant females as compared to non-pregnant females. HOMA-IR was also insubstantially lower in metformin-treated patients against control groups. There was a significant increase in pregnancy rates in metformin-treated patients (73.3% vs 26.7%; p=0.027).In conclusion, metformin therapy, either before or during ICSI cycles, significantly increases the rates of clinical pregnancy in women with PCOS. A large-scale category-wise study needs to be relied on in order to confirm the effects of metformin on the outcome of pregnancy in PCOS women undergoing the ICSI cycle because of its effect on HOMA-IR

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