It's an increasingly common phenomenon: A drug that was originally synthesized for a specific purpose turns out to be effective in combating another problem. Examples include Viagra (an unsuccessful treatment for angina that succeeded as an erectile dysfunction drug) and Thalidomide, a disastrously ineffective medication for pregnancy-induced nausea that has been proven to fight bone marrow cancer [source: Brown]. Metformin can also be included in this list, but with one significant difference. Not only is it helpful in a secondary role, but it's wildly popular in treating the condition for which it was initially intended.
Metformin was developed in the 1950s as a treatment for diabetes [source: Diabetes Forecast]. Today it's the most popular drug on the market for people with Type 2 diabetes [source: Science Daily]. But by 2004, Metformin was receiving international acknowledgement as a worthwhile option for patients seeking a remedy for their infertility. The U.K.'s National Collaborating Centre for Women and Children's Health noted that the drug, when used in conjunction with other medications, improved the rate of pregnancy in women with specific infertility issues tied to ovaries containing multiple cysts [source: NCCWCH].
The common denominator between Type 2 diabetes, Metformin and infertility can be described in one word: insulin. Insulin carries blood sugar to the body's cells to create energy. Some people's bodies, however, produce too little insulin, or the cells in the body refuse to accept the sugar it's transporting [source: American Diabetes Association]. That can lead to a multitude of health issues. Women whose infertility is tied to polycystic (multiple cysts) ovarian syndrome often have issues with insulin resistance. That's where Metformin comes in.
Why Metformin Is Prescribed for Infertility
Type 2 diabetes and polycystic ovarian syndrome are often linked with obesity [source: Baby Med]. Approximately 80 percent of Type 2 diabetes patients are either overweight or obese, and more than half of women with PCOS fall into those categories as well [source: Obesity in America.] It's far more difficult, and sometimes impossible, for the human body to maintain a healthy blood sugar level if a person is overweight or obese. Without healthy blood sugar levels, complications begin to arise. The role of Metformin is to establish properly balanced blood sugar and insulin levels [source: Fertility Authority].
Proper blood sugar and insulin levels can help prevent or reduce cysts. When cysts are removed, menstrual cycles tend to become more regular. When menstrual cycles are more predictable, the chances of becoming pregnant increase.
Generally, Metformin is recommended for women with a Body Mass Index above 25 [source: NCCWCH]. There are instances, however, in which Metformin can improve the fertility of women who are neither overweight nor obese. That's because insulin resistance can develop even in people with average or below-average body weight. So, technically speaking, it's the issue of insulin resistance and not necessarily unhealthy body weight that has to be treated to improve the odds of becoming pregnant [source: Elsner]. A change in eating habits alone doesn't always influence fertility.
Metformin can work within days to a few months depending on the woman and her particular medical history. But it's not without its side effects. Some women choose to discontinue use of Metformin because of nausea, diarrhea and other gastrointestinal issues. In rare cases, it can also lead to lactic acidosis -- a serious condition that may be marked by extreme tiredness, a change in skin color or muscular pain [source: WebMD].
Can Metformin alleviate anovulation?
Ovulation is not just the process by which an ovary releases an egg; it's marked by the release of a mature egg. An immature ovum causes a cycle that is anovulatory [source: Hernandez-Rey]. Anovulatory cycles or anovulation ensure infertility.
The causes of anovulation can range anywhere from problem with the hypothalamus to the early onset of menopause [source: Stanford]. Polycystic ovarian syndrome is one potential cause [source: Sherbahn]. A woman diagnosed with PCOS can be given various instructions and/or medications by her doctor. Metformin is one such medication. Clomid may be prescribed in conjunction with Metformin to treat PCOS. Once normal insulin levels are seen and menstruation occurs at regular intervals, anovulation may be alleviated [source: Labor of Love]. Those factors increase the chances of a woman becoming pregnant.
Fertility drugs, such as those that hyperstimulate the ovaries, have led to an increase in multiple births [source: Science Daily]. Metformin, however, does not fall into the category of COH (controlled ovarian stimulation) drugs. Since its purpose is to restore insulin production to normal levels and treat PCOS, it has not been linked to an increase in pregnancies involving twins, triplets and other births of more than one child. This fact makes Metformin different than most fertility medications [source: Labor of Love].
Metformin is not an across-the-board treatment for infertility. It has been proven effective in specific cases involving medical issues related to high blood sugar, insulin resistance and polycystic ovarian syndrome. A qualified physician can determine its appropriateness and whether it should be used alone or in combination with other treatments.
- American Diabetes Association. "Type 2." (May 30, 2012) http://www.diabetes.org/diabetes-basics/type-2/
- American Pregnancy Association. "Understanding Ovulation." (June 2, 2012) http://www.americanpregnancy.org/gettingpregnant/understandingovulation.html
- Baby Med. "Seven Easy Steps to Improve Your Fertility and Get Pregnant." (May 30, 2012) http://www.babymed.com/getting-pregnant/seven-easy-steps-improve-your-fertility-and-get-pregnant
- Brown, David. "Collaboration Seeks to Find News Uses for Failed Drugs." May 3, 2012. (May 31, 2012) http://www.washingtonpost.com/national/health-science/collaboration-seeks-to-find-new-uses-for-failed-drugs/2012/05/03/gIQAA81D0T_story.html
- Diabetes Forecast. "The Origins of Metformin." December 2010. (May 30, 2012) http://forecast.diabetes.org/magazine/origins-metformin
- Elsner, Carline W. MD. "Fertile Thoughts: Metformin and Polycystic Ovarian Syndrome." (May 30, 2012) http://www.divinecaroline.com/22094/27877-fertile-thoughts-metformin-polycystic-ovarian
- Fertility Authority. "PCOS: Diagnosis and Treatment." (May 30, 2012) http://www.fertilityauthority.com/fertility-issues/what-causes-polycystic-ovarian-syndrome-pcos/pcos-diagnosis-treatment
- Hernandez-Ray, Armando E. MD. "Anovulation." Oct. 25, 2011 (May 30, 2012) http://emedicine.medscape.com/article/253190-overview
- Life Tips. "What does insulin do?" May 30, 2012 http://diabetes.lifetips.com/faq/112911/0/what-does-insulin-do/index.html
- National Collaborating Centre for Women's and Children's Health. "Fertility." February 2004 (May 30, 2012) http://www.nice.org.uk/nicemedia/pdf/cg011fullguideline.pdf
- Obesity in America. "Obesity and Type 2 Diabetes." (June 2, 2012) http://www.obesityinamerica.org/understandingObesity/diseases.cfm
- Science Daily. "Fertility Drugs Contribute Heavily to Multiple Births." (June 2, 2012) http://www.sciencedaily.com/releases/2010/01/100120104002.htm
- Science Daily. "Metformin May Lower Risk for Oral Cancer Development." March 12, 2012. (May 31, 2012) http://www.sciencedaily.com/releases/2012/03/120331151138.htm
- Sherbahn, Richard. MD. "Polycystic Ovarian Syndrome Fertility with Metformin (Glucophage.)" Advanced Fertility Center of Chicago. (May 31, 2012) http://www.advancedfertility.com/metformin-pcos-pregnancy.htm
- Stanford. "What Causes Female Infertility?" (June 2, 2012) http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/Causefem.htm
- The Labor of Love. "How Long Does it Take for Metformin to Work?" (May 30, 2012) http://www.thelaboroflove.com/articles/how-long-does-it-take-for-metformin-to-work
- WebMD. "Metformin Oral." (May 30, 2012) http://www.webmd.com/drugs/mono-7061-METFORMIN+-+ORAL.aspx?drugid=11285&drugname=metformin+oral