Influence of metformin on pregnancy outcomes and endometrial receptivity of patients with PCOS undergoing IVF/ICSI treatment

Sun Dongxia; Wang Jingyuan; Zhao Zheqi; Chang Ziyin; Zhai Jun

doi:10.3969/j.issn.1004-437X.2017.09.002

Abstract：Objective To explore the influence of metformin on pregnancy outcomes and endometrial receptivity of polycystic ovary syndrome (PCOS) infertile women with insulin resistance (IR) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).Methods PCOS patients who underwent IVF/ICSI were divided into metformin group (group A) and control group (group B).Patients in group A received metformin with a dose of 500 mg tid from the second to fifth day of menstrual period or with drawal bleeding until the sixth day of ovum pick-up (OPU), and no metformin was provided for group B.The reproductive parameters of group A and B were compared.Endometrial tissue were from PCOS patients who were cancelled for the high risk of ovarian hyperstimulation syndrome (OHSS) in IVF/ICSI.Endometrial tissue were divided into group A1(n=3) and B1 group (n=3), and western blot was used to detect the expression of HOXA10 and ITGB3.Results There was no significant difference of two groups in the number of days of Gn and its total, number of oocytes retrieved, normal fertilization rate, excellent embryo rate and endometrial thickness (P>0.05).The clinical pregnancy rate of group A was significantly higher than that of group B(P<0.05).Meanwhile, the E2 level on HCG day, cycle cancellation rate, miscarriage rate and the incidence of OHSS in group A were significantly lower than that of group B (P<0.05).The levels of HOXA10 and ITGB3 expression in A1 group were significantly higher than that of B1 group (P<0.05).Conclusion For PCOS infertility patients with IR in IVF/ICSI, metformin pretreatment can improve clinical pregnancy rate, reduce abortion rate and OHSS incidence, and improve endometrial receptivity.