Effects of Metformin on Early Pregnancy Loss in Patients with Polycystic Ovary Syndrome (PCOS)

Abstract

Objective: To determine the outcome of metformin therapy in early pregnancy loss in women with polycystic ovary syndrome (PCOS) at Tertiary Care Hospital, Karachi.

Methodology: This descriptive cross-sectional study was conducted at Department of Gynecology and Obstetrics, Civil Hospital, Karachi, from February 2021 till August 2022. Newly diagnosed pregnant women, aged age of 18-40 years, gestational age ≤ 4 weeks with polycystic ovary syndrome before pregnancy and started on metformin therapy were enrolled. Patients were started on metformin therapy (1000 mg/day) and were followed by the researcher to evaluate the occurrence of early pregnancy loss. All the relevant data of the study were entered and statistically analyzed by the IBM SPSS Statistics, Version 23. Moreover the frequency of early pregnancy loss was computed and post stratified based on effect modifiers by applying chi-square test taking p-value (<0.05) as statistically significant.

Results: Mean age and duration of PCOS in our study was 32.58±4.51 years and 5.72±2.89 years. Out of 125 patients, 32 (25.6%) patients were observed with early pregnancy loss. Moreover, the incidence of early pregnancy loss was statistically insignificant according to maternal age, parity, residential status and SES (p>0.05)

Conclusion: Metformin observed to be a protective management therapy to significantly reduces the early pregnancy loss among women with PCOS, possibly by correcting IR, hyperinsulinemia, and androgen excess the key metabolic drivers of miscarriage.