We all get excited about new things. But most people remain skeptical when you suggest that something old may be better. In fact, what if something VERY old may be one of the hottest developments in a high tech field like fertility treatment? That’s what has been quietly happening with the medication known as metformin.
Metformin has been used since the time of the pharaohs (around 1500 B.C.E.) but it was extracted from the plant Galega officinalis (see image). From then until the discovery of insulin; this was the primary treatment for diabetes. Unfortunately, like many plant extracts there were many other compounds present as well—some with serious and/or troubling side effects. The modern synthesized version of metformin has been purified making it safer and easier to study.
The best known use of metformin in reproductive medicine is in the treatment of women with polycystic ovarian syndrome (PCOS). But we’re now learning that there are many other ways that his modern version of an herbal remedy can help improve the outcome of fertility treatment. Although I’m not a fan of lists, the complexity of this treatment is beyond a simple blog post. So here is what you may want to consider when planning your treatment with your doctor:
In summary, pregnancy is a very multifaceted process. Sometimes, we still have a lot to learn about something that has been around for a long time.
Here’s another fascinating study for women with PCOS; 1500 mg of the potent antioxidant from red wine can reduce testosterone levels by nearly 25%. This can not only improve egg quality and pregnancy rates but also reduce other symptoms of PCOS as well!
Coffee has remained a matter of debate and controversy for some time in the fertility world. Initially it was thought to promote miscarriages and reduce uterine blood flow. Newer data is suggesting that it can reduce the risk of diabetes and may actually promote arterial blood flow. Until more information is obtained or you have been specifically advised by your provider to abstain from coffee; practice moderation or consider tea! Here’s a great video to bolster your confidence. http://nutritionfacts.org/video/coffee-and-artery-function/
There is a a growing body of evidence that the outdated idea that soy inhibits fertility needs to be abandoned. There are too many studies now that have found the exact opposite. Here is one just published regarding women with PCOS: http://www.medpagetoday.com/endocrinology/metabolicsyndrome/59561
The greatest healthcare challenge facing us as a society today is related to obesity. It is now estimated that by 2030, 42% of the population in the USA will be obese resulting in a rise in healthcare costs of nearly $149 billion per year. But beyond the financial cost is the impact that obesity has on an individual basis. It is clearly the leading risk factor in the development of heart disease, diabetes and many forms of cancer. Clearly any one of us would like to minimize the impact that this could have upon our own child. New research has confirmed that our efforts to insure a child’s healthy future should begin even before that child has been conceived. Theories were proposed nearly two decades ago that a child’s life-long health risks for problems like diabetes begin shortly after conception. But it is within the last 5 years or so that studies actually began to prove that characteristics like a person’s ability to regulate their body weight can be permanently altered by their mother being overweight or obese during pregnancy. That’s because our ability to regulate our calorie balance (i.e., hunger, satiation, metabolism, etc) has to do with the hormonal and chemical balance that our developing brain was exposed to during fetal development. Although the early studies were done on animals, it hasn’t taken long to establish similar ties in humans as well. For instance, one recent study found that for every 22 lbs that a woman was overweight prior to pregnancy, her baby’s birthweight would predictably be about a half of a pound over the average. Then for each additional 10kg that an overweight woman gains during pregnancy, her child’s birthweight increases by an additional half pound. Along with this higher birth weight is a higher risk of cesarean section and subsequent health problems in childhood. That’s because birthweight is the earliest predictor of how our physiology will respond to our high-calorie and increasingly sedentary lifestyle. Babies either above or below the averages are at highest risk of being overweight or obese before they reach puberty. It has been confirmed that when overweight or obese women become pregnant, their children are at high risk of developing problems with high blood pressure, elevated cholesterol and an increased risk of becoming diabetic before they complete their teenage years. Recently, the Center for Disease Control and Prevention revealed the shocking statistic that nearly one in four adolescents today has diabetes or pre-diabetes. That’s nearly triple the rate of just a decade earlier—an alarming increase. So while we work toward finding more treatment options for overweight children and teens, we should also put greater effort toward identifying and assisting women at risk. Intervention before they become pregnant and during pregnancy can not only improve their health (and fertility), but their child’s entire future. Here are just a few of the strategies that have been shown to work: • Whenever possible, assist patients in losing weight prior to conception • Encourage healthy nutrition during pregnancy • Promote exercise during pregnancy • Identify and treat insulin resistance as early as possible (preferably prior to conception) • Encourage breast feeding—helps mom get back to healthy weight after delivery while reducing rapid weight gain in newborn infants • Avoid hormone disrupting chemicals like bisphenonal A (BPA)—which have been linked with excessive weight gain
*The following is an excerpt from my book PERFECT HORMONE BALANCE FOR FERTILITY[u1] . If you’re working to lose weight or wondering if/how this may improve your chance for conception then read on…
Fat cells are not passive calorie warehouses, but rather mini endocrine factories that produce at least 20 different hormones, collectively called adipokines. These hormones direct your metabolism and help your brain keep track of your energy stores to control appetite and budget how your body uses this energy. Adipokines also help your brain determine if you have enough fat stores to sustain pregnancy. Your brain also takes into account how effectively you can share your energy with your baby—if you’re insulin-resistant, your body doesn’t channel energy to the fetus as effectively. As you modify your diet, fat cells adjust their adipokine secretions to bring them more into balance, improving your fertility profile. Here are some of the key adipokines and how they affect your weight.
- Leptin tracks how many calories you have stored as fat—the more fat you have, the more leptin in your blood. When leptin levels are high, your brain suppresses your appetite and revs your metabolism to help you burn calories. But when leptin is chronically elevated, at it is in obesity, your brain tunes out the appetite-suppressing effect. Low leptin, on the other hand, signals low fat stores—a red flag that your brain should halt ovulation.
- Adiponectin helps your body use fat as fuel. As you gain weight, though, you produce less adiponectin, and low levels are associated with fertility problems. As you lose weight, fat cells release more adiponectin, increasing your chance of conception.
- Resistin is released by fat cells, resisting insulin’s ability to help store glucose. If you’re overweight, resistin rises, leading to insulin resistance and reduced fertility.
Most people have accepted the role of reducing insulin resistance in order to improve
fertility and reduce miscarriage in women with PCOS. The question that often comes
up is what is the most strategy to achieve this goal. True there are many dietary and
lifestyle modifications that can improve insulin sensitivity. The problem is that each
person needs a different combination of recommendations tailored to their unique
situation. That’s why having a simple and well researched medication to prescribe is
such a bonus. Metformin meets these needs.
Not only has metformin been shown to improve fertility; it has also been linked to
a reduced risk of miscarriage as well. Now there is a growing body of evidence that
metformin can reduce the risk of various cancers.
Many studies have shown the type II diabetes—the most severe form of insulin
resistance—is associated with elevated risks of various types of cancer. So it has long
been hoped that the types of medications that can reduce insulin resistance should also
reduce cancer risks. Better still; the data that has emerged with the use of metformin
has also been associated with a reduced risk of endometrial (uterian) cancer and breast
So if you’ve got insulin resistance and want to become pregnant, there is even more
compelling reasons to consider metformin as part of your treatment regimen.