The Effect of metformin on outcome of Intrauterine insemination (IUI) in insulin non-resistant infertile women with polycystic ovarian syndrome

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran.

2 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: polycystic ovary syndrome is the common cause of infertility due to anovulation, and insulin resistance, increasing high body mass Index and waist: hip ratio (WHR) are known risk factors in poor outcome of infertility treatment and also clinical response to metformin. This study was performed with aim to assess the effect of metformin on prediction of treatment outcomes of IUI in insulin – resistant and non-resistant infertile women with polycystic ovarian syndrome (PCOS) and the effect of resistant to insulin, BMI and WHR on them.
Methods: This non randomized clinical trial study was performed on 74 infertile women with PCOS who were candidate for IUI referred to infertility clinic of Mirza Koochackan Hospital of Tehran between 2011 and 2012. The patients were divided in two groups of Insulin Resistance and nonresistance according to the results of GTT(Glucose Tolerance Test) and Insulin level hormone test and were divided to four groups according to BMI. All patients received metformin 500mg, three times daily, six weeks before the IUI cycle and both groups subsequently underwent treatment with drugs of ovulation induction for IUI. Data were analyzed with T-test and ANOVA test. PResults: from 74 studied women, 34 cases were insulin resistance and 37 nonresistance. Treatment with metformin caused more ovulation rate, mean follicular size, positive result of pregnancy test, clinical pregnancy and adverse effects in Insulin resistance group, but these differences were not significant (P>0.05). But, two groups showed a significant difference in BMI and WHR ratio (P=0.02). 11 cases (29.7%) in resistance group and 9 (24.3%) in nonresistance group become pregnant, but this difference was not significant (P>0.05). In four indexes, two groups were not statistically significant in terms of IUI results and pregnancy incidence (P=0.05). But, in over weigh patients (BMI=25-30) in both groups, more pregnancy rate was observed.
Conclusion: Metformin can be administered for all PCOS patient regardless of Insulin resistant and nonresistance. Also BMI is a better predictor for the rate of response to treatment with metformin.

Keywords

References

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