Metformin in EKO

[logyn]

Situation sledushchaja. SPKJA. BMI 23.

2 unsuccessful reports.

-Gonal-F 150+Suprefact. 18 YAK, was impregnated 9 ICSI. Carry for the third day of two 8 embrinov. Failure.

-Gonal-F 225+Decapeptyl 0.1 24 YAK, from them 14-mature, it was impregnated 11. ICSI. Carry for the third day 3 embrinov (two 7 cellular + one 8 cellular) Failure.



By publications in an Internet, there is a positive influence of use of Metforminum in preparation for the report on quality of embryoses, and so for percent or interest beremennostej.

Express, please, the opinion.



ZY: I Wish to understand, whether it is necessary to discuss use of Metforminum with the doctor.

[Melnichenko]

Metforminum has triumphally come in reproduktologiju-but nevertheless for opredlennoj categories 0-with proved insulinorezistentnostju (that is more likely connected with an obesity). You do not have obesity and is not present proved insulinorezistentnosti.

However, the triumph of Metforminum hardly can be extrapolated on IVF protookly. In a word, a word for Boris Kamenetskim, on me idea disputable (it is better to tell or say. More than disputable).

[logyn]

Here pair clauses or articles, suggested an idea me.

Unfortunately I not reproduktolog, therefore to estimate or appreciate a degree of reliability of the given researches to me it is complex or difficult.

http: // humrep.oxfordjournals.org/cgi/content/abstract/19/6/1315? maxtoshow = and amp; HITS=10*amp; hits=10*amp; RESULTFORMAT = and amp; fulltext=metformin*amp; searchid=1138297791132_2783*amp; FIRSTINDEX=0*amp; journalcode=humrep



http: // www.ncbi.nlm.nih.gov/entrez/query.fcgi? cmd=Retrieve*amp; db=pubmed*amp; dopt=Abstract*amp; list_uids=11239532*amp; query_hl=1*amp; itool=pubmed_docsum

[Melnichenko]

And other clauses or articles in which Metforminum has not given additional effect, serve you as the basis for its or his application?

[logyn]

Probably, I something neulovila.

Here citations

However, in the normal weight subgroup (BMI *lt; 28 kg/m2, n = 27), pregnancy rates following IVF were 0.71 (0.63-0.79) versus 0.23 (0.15-0.31) in the metformin and placebo groups, respectively (P = 0.04).

However, in the normal weight subgroup, clinical pregnancy rates were 0.67 (0.43-0.91) and 0.33 (0.06-0.60), respectively (P = 0.06).

However, among normal weight PCOS women, pre-treatment with metformin tends to improve pregnancy rates.



However, the mean number of mature oocytes (18.4 +/-1.5 vs. 13 +/-1.5) and embryos cleaved (12.5 +/-1.5 vs. 5.9 +/-0.9) were increased after metformin treatment. Fertilization rates (64 % vs. 43 %) and clinical pregnancy rates (70 % vs.30 %) were also increased.

Metformin use appears to improve IVF outcomes in patients with clomiphene citrate-resistant PCOS.

[Melnichenko]

C my point of view, here where last phrase is more important.



CONCLUSIONS: Pre-treatment with metformin prior to conventional IVF/ICSI in women with PCOS does not improve stimulation or clinical outcome. However, among normal weight PCOS women, pre-treatment with metformin tends to improve pregnancy rates. Further studies in subgroups of PCOS women are required.

[logyn]

And in your citation there is it *quot; n?a*quot; for women with normal weight what I also am:)



Edistvennoe, I as already wrote, not in a status objectively to estimate or appreciate reliability of these researches, by virtue of small experience:)

[Melnichenko]

Yes is not present, in my citation (as well as in yours, time is one citation) the main thing that the further researches bole vsgo are required is remembered last phrase as Stirlitz used to say, and the epopee with small IMT drops out of all before the come ideas on Metforminum. She (idea) can be the truth, and can be statistically significant fact (but not klincheski).

T.e it was small pilot research. If your doctor considers or counts possible or probable to change on the basis of this clause or article to you the scheme or plan of treatment (you asked, whether to speak you with the doctor), he should write down in history bolezin, that as the patient has given to him, the doctor, such clause or article, and he, the doctor, supposes, that results of this small research can be primenimy and to its or his patient (on ITS or her pavor and risk and under ITS or her offer) he sees an opportunity of such addition to the scheme or plan of treatment.

You in fact sprapshivali, whether it is possible to discuss with the doctor these data?

Certainly, it is possible.

And here what is this data - from the point of view of another vracha-it is the pilot data demanding additional researches.

[boris]

Uv. logyn!

Really there is a mass of publications concerning application of Metforminum at sterility or barrenness (usually at women with superfluous mass of a body and SPKJA, and also at some thin (if there are bases to think about insulinorezistentnosti)).

As if to application of this preparation in eko (also it is usual at women of the above described group), as auxiliary (more often preliminary therapy) I have found only four randomizirovannyh researches (I I have in view of the publication of foreign authors) in which data about utility of similar therapy are rather doubtful.

[logyn]

Dear doctor Melnichenko and doctor Kamenetsky, many thanks to you for the interest shown to my question and for answers.

The picture has a little cleared up:).



If it is possible, one more question. How it is possible to affect or influence quality of oocytes? On quantity or amount of mature oocytes?