Effects of Metformin on Hyperinsulinemia, Hyperandrogenism and Reproduction in Women with Polycystic Ovarian Syndrome - Abstract
Polycystic Ovary Syndrome (PCOS) is characterized by ovulatory disturbances, hyperandrogenaemia and hyperinsulinemia secondary to increased insulin resistance. In PCOS, hyperinsulinemic insulin resistance is of interest because skeletal muscle may be resistant to insulin in terms of glucose metabolism, while the ovaries remain sensitive to insulin with regard to stimulation of testosterone biosynthesis. Insulin resistance and hyperinsulinemia are associated with reproductive failure such as early pregnancy loss, and cardiovascular risk and the development of diabetes mellitus later in life. Insulin-sensitizing agents such as metformin improve insulin sensitivity, thereby improving ovulatory cycles and fertility in women with PCOS. Metformin has also been shown to retard progression to type 2 diabetes in PCOS. This review addresses the effects of metformin on reproduction