Drug Combination Increases Chance Of Pregnancy.(metformin and clomiphene citrate increases ovulation and chance of pregnancy in women with polycystic ovary syndrome)

2001 MAR 8 - (NewsRx.com) -- There may be new hope for women who are infertile due to polycystic ovary syndrome (PCOS).

A study published in the February 2001 issue of the journal Fertility and Sterility reveals that the drug metformin, when combined with the commonly used fertility drug clomiphene citrate, increases ovulation and the likelihood of pregnancy in patients who are unresponsive to clomiphene alone. The study was a joint effort between researchers from four medical centers.

From 4% to 6% of reproductive-age women suffer from PCOS, a condition that prevents regular ovulation. Many of these women ovulate so infrequently that conception is extremely challenging. Clomiphene citrate is a pill that has been used with relative success: about two-thirds of women who take the pill ovulate, and roughly one-third becomes pregnant. For those who do not respond, the only viable alternatives today are surgery and injectable fertility drugs, both of which have potentially dangerous side effects.

"We don't want to cause dangerous situations in women who are otherwise very healthy," says Valerie S. Ratts, MD, an assistant professor of obstetrics and gynecology at the Washington University School of Medicine in St. Louis. "It would be nice to have an alternative way to treat these women safely and effectively."

Research suggests that many of these women also have a type of insulin resistance similar to that seen in type 2 diabetes. The body produces excess insulin to ensure that all cells are sufficiently fueled. Researchers believe that increased levels of insulin may interrupt normal communication between the pituitary gland and the ovary.

"Normally, the ovary and pituitary glands talk to each other," explains Ratts. "We think that insulin interferes with the signals, like static. So maybe we should be attacking this problem by helping these women lower their insulin levels to get the cells to work properly." Once insulin levels are in balance, she says, patients may be more responsive to clomiphene citrate.

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