07-25-2005, 06:50 AM
Metformin increases ovulation in treating infertility caused by polycystic ovarian syndrome. Do you know WHY?
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Gyn. Q - hughzh
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07-25-2005, 06:53 AM
it might be due to metformin decreasing certain aspects of liver function.
the liver controls estrogen metabolism, and in polycystic disease, there is a hyperestrogen state.....just my thoughts 
07-25-2005, 07:09 AM
Women with PCOS who have impaired glucose tolerance, thus insuline resistance. Metformin reduces hepatic glucose output, improves insulin resistance and decrease hyperinsulinemia in these patients.
07-25-2005, 07:14 AM
revo & usmlega.....Thanks! But PCOS is high in LH and androgen not estrogen. And how to link decreased hyperinsulinemia to improved ovulation??????????
07-25-2005, 07:59 AM
There™s no one good explanation for that. I know for this one.
High levels of insulin will stimulate theca cells, which produce androgens & cause anovulations. Pts w/ PCOS are usually obese & have insulin resistance. Hyperinsulinemia can cause hyperandrogenism (theca cells are sensitive to insulin.), increase LH levels, decrease hepatic synthesis of sex binding globulin (SBG). Decreased levels of SBG will increase free circulating levels of androgens (testosterones) & estrogens. So the hypothesis is - by decreasing insulin resistance with metformin (& weight loss & diet) the side effects of hyperinsulinemia will be reverse. http://bmj.bmjjournals.com/cgi/content/f...7/7421/951 http://bmj.bmjjournals.com/cgi/content/f...7/7154/329
07-26-2005, 04:10 PM
Metformin maintains a balance between LH and FSH ratio.
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