Metformin use and Clinical Pregnancy Rate in women with Unexplained Infertility (A randomized controlled trial)

Abstract

n fact there is no consensus on which factors we should diagnose unexplained infertility, most of gynecologists diagnose it after evaluation of male partner by semen analysis and female partner by history, hormonal profile (FSH, LH, TSH and PRL) and tubal patency by HSG, hysteroscopy and or laparoscopy. There is controversy regarding treatment of unexplained infertility due to absence of specific pathophysiological rational which allows curative intervention. The main three lines of treatment of such cases are controlled ovarian hyperstimulation (to increase chances of pregnancy), IUI with spontaneous or induced ovulation and third is IVF. Some non-PCOs infertile women including those with unexplained infertility are associated with insulin resistance due to aging (paolisso G et al., 1999), stress (Vanltallie TB et al., 2002), depression (Wolkowitz OM et al., 2001), obesity(Bjorntorp P et al., 2000) and sedentary life style (Rosenthal M et al., 1983). That’s why metformin as an insulin sensitizer drug may has benefit in such cases. Metformin side effects includes gastrointestinal irritation and vitamin B12 deficiency with long term use, while regarding pregnancy there is no clear evidence suggest increasing congenital anomaly with metformin use.