I have written previous blog posts about the various ways that metformin can improve fertility treatment. These studies typically focus on the influence that this medication seems to have on becoming pregnant. We now have compelling evidence that this medication can also optimize your chance of completing your pregnancy. In other words, metformin is associated with a reduction in the risk of miscarriage.
Most miscarriages occur in the first trimester. It is estimated that 80% of pregnancy losses occur within the first 6 to 12 weeks of pregnancy. Previous research has shown that use of metformin may help reduce this risk due to various ways that it seems to influence egg quality and by stabilizing first trimester hormone shifts. Now a study has found that continuing metformin reduces the risk of later miscarriage by 50%!
A very well designed study followed nearly 500 women in 14 difference centers as their pregnancies progressed. These women had been randomly assigned to take metformin based upon a previous diagnosis of risk due to either PCOS or concerns of potential gestational diabetes. Unfortunately, 10% of women taking the placebo lost their pregnancy after the first trimester. But the women taking metformin had less than half as many pregnancy losses! Since no other treatment has demonstrated a comparable ability to reduce the risk of second trimester loss—these results are pretty impressive.
So if you feel that you may be at risk of second trimester pregnancy loss or gestational diabetes; discuss with your provider whether or not you may be a candidate for metformin.
Robert Greene, MD, FACOG
Conceptions Reproductive Associates