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Metformin in High Responder Polycystic Ovary Syndrome (PCOS) Patients Undergoing IVF Cycles

This study has been completed.
Information provided by:
University Magna Graecia Identifier:
First received: October 8, 2010
Last updated: June 9, 2011
Last verified: June 2011

The use of metformin pre-treatment and co-administration was recently proposed in infertile women affected by polycystic ovary syndrome (PCOS) treated with gonadotropins.

Data from meta-analyses showed that metformin administration significantly reduced the stimulation length and the total dose of gonadotropins used in PCOS women undergoing gonadotropins stimulation for non in-vitro fertilization (IVF) cycles. On the other hand, in IVF cycles metformin was demonstrated to significantly reduce the ovarian hyperstimulation syndrome (OHSS) rate in infertile patients with PCOS treated with gonadotropins.

The metformin regulating effect on the ovarian response was also observed in a randomized controlled trial (RCT) on young non-obese insulin-resistant women with PCOS receiving gonadotropins for mono-ovulation induction. In particular, metformin increased the mono-ovulatory cycles, the duration of stimulation and the amount of gonadotropins used, while it reduced the number of dominant follicles and the estradiol (E2) levels.

The aim of the present study was to evaluate the effect of metformin administration in high responder PCOS patients undergoing gonadotropins ovarian stimulation for IVF cycles.

Condition Intervention Phase
Infertility Polycystic Ovary Syndrome (PCOS) Drug: Metformin Drug: Placebo administration Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Metformin Addition to Gonadotropins Ovarian Stimulation in High Responder Patients With PCOS Undergoing In-vitro Fertilization

Resource links provided by NLM:

Further study details as provided by University Magna Graecia:

Primary Outcome Measures:
  • Rate of OHSS [ Time Frame: one month ]

Secondary Outcome Measures:
  • Stimulation length [ Time Frame: one month ]
  • Gonadotropins dose [ Time Frame: one month ]
  • Dominant follicles on day of ovulation triggering [ Time Frame: one month ]
  • Ovulation rate [ Time Frame: one month ]
  • Peak estradiol levels on day of ovulation triggering [ Time Frame: one month ]
  • Embryo quality [ Time Frame: one month ]
  • pregnancy rate [ Time Frame: one month ]
  • multiple pregnancy rate [ Time Frame: one month ]
  • Live birth rate [ Time Frame: ten months ]

Enrollment: 120
Study Start Date: May 2009
Study Completion Date: January 2011
Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Experimental group
Patients receiving metformin pretreatment and co-administration
Drug: Metformin
Metformin pre-treatment and co-administration
Placebo Comparator: Control group
Drug: Placebo administration
Placebo pre-treatment and co-administration

Detailed Description:

Infertile young non-obese insulin-resistant patients with PCOS who had a background of the first IVF treatment cycle cancelled because of high risk for OHSS will be enrolled and randomized in two treatment arms.

In their second IVF attempt, the experimental group will receive metformin (500 mg, 3 times daily) pre-treatment for two weeks and co-administration during gonadotropins ovarian stimulation; the control group will be treated with placebo (2 cps daily) pre-treatment and co-administration by using the same schedule of the experimental group. In all patients, ovarian stimulation will be carried out with a personalized step-down gonadotropin in association with a minidose flare-up GnRH agonist protocol.


Ages Eligible for Study:   18 Years to 35 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • History of one previous cancelled cycle for high-risk of OHSS, or history of moderate/severe OHSS during their previous IVF cycle
  • Infertility
  • Polycystic ovary syndrome (PCOS)
  • insulin resistance
  • hyperandrogenism

Exclusion Criteria:

  • BMI>30 kg/m2
  • age >35 years
  • FSH>9UI/L
  Contacts and Locations
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Please refer to this study by its identifier: NCT01233206

Pugliese" Hospital
Catanzaro, Italy, 88100
Sponsors and Collaborators
University Magna Graecia
Principal Investigator: Stefano Palomba University Magna Graecia
Study Chair: Fulvio Zullo University Magna Graecia
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Department of Obstetrics and Gynecology, University Magna Graecia Identifier: NCT01233206     History of Changes
Other Study ID Numbers: 04/2010
Study First Received: October 8, 2010
Last Updated: June 9, 2011

Keywords provided by University Magna Graecia:
Polycystic ovary syndrome
Cancelled cycles

Additional relevant MeSH terms:
Polycystic Ovary Syndrome
Pathologic Processes
Genital Diseases, Male
Genital Diseases, Female
Ovarian Cysts
Ovarian Diseases
Adnexal Diseases
Gonadal Disorders
Endocrine System Diseases
Hypoglycemic Agents
Physiological Effects of Drugs processed this record on August 18, 2017