A systematic review of the reproductive system effects of metformin in patients with polycystic ovary syndrome
Open accessAbstract
Objective To review the effectiveness of metformin in restoring regular menstrual cycles and ovulation and achieving pregnancy in women with polycystic ovary syndrome (PCOS).Design Systematic review of pertinent studies identified using the bibliographic databases MEDLINE and EMBASE. References of selected articles identified were hand-searched for additional relevant citations.Patient(s) Women with PCOS undergoing treatment with metformin alone, metformin combined with other methods of ovulation induction such as clomiphene citrate (CC) or gonadotropin injections, or metformin combined with in vitro fertilization (IVF).Result(s) Thirty published studies were included in the overall review. Studies consisted of 12 randomized controlled trials, two cohort studies, and 16 uncontrolled descriptive studies. Due to a strong variability in the use of metformin according to study population, exposure, and outcome of interest, it was not possible to combine the data of the 12 randomized controlled trials to perform a meta-analysis. Limited data on predominately obese PCOS patients demonstrate that metformin alone improves both restoration of regular menses and spontaneous ovulation, but there are no data supporting an improvement in pregnancy rate. The addition of metformin to CC results in an improved ovulation and pregnancy rate in both unselected and CC-resistant PCOS women. There are insufficient data to make any conclusions on the effect of metformin on FSH ovulation induction or IVF.Conclusion(s) The effectiveness and role of metformin in the treatment of PCOS anovulatory infertility in clinical practice is difficult to assess from currently available research. Further well-designed prospective, perhaps multicenter, randomized controlled trials with the primary end point of pregnancy or live-birth rate are required.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Studies examining the reproductive effects of metformin in PCOS suggest benefits but are limited by study design.
“Studies examining the reproductive effects of metformin in PCOS suggest benefits but are limited by study design. 223”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [223]
Cites
Users' guides to the medical literature
Guyatt, G. H. (1993) · JAMA · doi:10.1001/jama.270.17.2096 · Cited by 2,970 · see citing works
Insulin Resistance and the Polycystic Ovary Syndrome: Mechanism and Implications for Pathogenesis
Dunaif, A. E. (1997) · Endocrine Reviews · doi:10.1210/edrv.18.6.0318 · Cited by 2,761 · see citing works
Franks, S. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509283331307 · Cited by 2,463 · see citing works
Profound Peripheral Insulin Resistance, Independent of Obesity, in Polycystic Ovary Syndrome
Dunaif, A., Segal, K. R., Futterweit, W., & Dobrjansky, A. (1989) · Diabetes · doi:10.2337/diab.38.9.1165 · Cited by 1,967 · see citing works
Bailey, C. J., & Turner, R. C. (1996) · New England Journal of Medicine · doi:10.1056/nejm199602293340906 · Cited by 1,726 · see citing works
The Existence of Publication Bias and Risk Factors for Its Occurrence
Dickersin, K. (1990) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1990.03440100097014 · Cited by 1,417 · see citing works
Andrology: Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients
Balen, A. H., Conway, G. S., Kaltsas, G., Techatraisak, K., Manning, P. J., West, C., & Jacobs, H. S. (1995) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a136243 · Cited by 1,060 · see citing works
Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism.
Adams, J., POLSON, D. W., & Franks, S. (1986) · BMJ · doi:10.1136/bmj.293.6543.355 · Cited by 975 · see citing works
Users' Guides to the Medical Literature
Guyatt, G. H. (1993) · JAMA · doi:10.1001/jama.1993.03510210084032 · Cited by 941 · see citing works
Insulin-Like Growth Factors as Intraovarian Regulators of Granulosa Cell Growth and Function*
Adashi, E. Y., Resnick, C. E., D’Ercole, A. J., SVOBODA, M. E., & Wyk, J. J. V. (1985) · Endocrine Reviews · doi:10.1210/edrv-6-3-400 · Cited by 911 · see citing works
NESTLER, J. E., POWERS, L. P., MATT, D. W., STEINGOLD, K. A., PLYMATE, S. R., RITTMASTER, R. S., CLORE, J. N., & BLACKARD, W. G. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-72-1-83 · Cited by 815 · see citing works
Users' Guides to the Medical Literature
Oxman, A. D. (1994) · JAMA · doi:10.1001/jama.1994.03520170077040 · Cited by 813 · see citing works
Franks, S. (1997) · Archives of Disease in Childhood · doi:10.1136/adc.77.1.89 · Cited by 802 · see citing works
Nestler, J. E., Jakubowicz, D. J., Evans, W. S., & Pasquali, R. (1998) · New England Journal of Medicine · doi:10.1056/nejm199806253382603 · Cited by 781 · see citing works
Nestler, J. E., & Jakubowicz, D. J. (1996) · New England Journal of Medicine · doi:10.1056/nejm199608293350902 · Cited by 743 · see citing works
Moghetti, P., Castello, R., Negri, C., Tosi, F., Perrone, F., Caputo, M., Zanolin, E., & Muggeo, M. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.1.6293 · Cited by 660 · see citing works
Pasquali, R., Gambineri, A., Biscotti, D., Vicennati, V., Gagliardi, L., Colitta, D., Fiorini, S., Cognigni, G. E., Filicori, M., & Morselli-Labate, A. M. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.8.6738 · Cited by 635 · see citing works
Barbieri, R. L., Makris, A., Randall, R. W., Daniels, G. H., Kistner, R. W., & Ryan, K. J. (1986) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-62-5-904 · Cited by 629 · see citing works
POLYCYSTIC OVARY SYNDROME: A CHANGING PERSPECTIVE
Franks, S. (1989) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1989.tb00457.x · Cited by 523 · see citing works
Oxman, A. D. (1994) · JAMA · doi:10.1001/jama.272.17.1367 · Cited by 486 · see citing works
Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies
Hull, M. G. R. (1987) · Gynecological Endocrinology · doi:10.3109/09513598709023610 · Cited by 423 · see citing works
Nestler, J. E., & Jakubowicz, D. J. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.12.4431 · Cited by 394 · see citing works
Dunn, C. J., & Peters, D. H. (1995) · Drugs · doi:10.2165/00003495-199549050-00007 · Cited by 391 · see citing works
Fleming, R., Hopkinson, Z. E., Wallace, A. M., Greer, I. A., & Sattar, N. A. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.2.8261 · Cited by 366 · see citing works
How to Use an Article About Therapy or Prevention
Guyatt, G. H., Sackett, D. L., & Cook, D. J. (1995) · Cited by 357 · see citing works
Vandermolen, D. T., Ratts, V. S., Evans, W. S., Stovall, D. W., Kauma, S. W., & Nestler, J. E. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01675-7 · Cited by 356 · see citing works
Ehrmann, D. A., Cavaghan, M. K., Imperial, J., Sturis, J., Rosenfield, R. L., & Polonsky, K. S. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.2.3722 · Cited by 346 · see citing works
Diamanti‐Kandarakis, E., Kouli, C., Tsianateli, T. C., & Bergiele, A. T. (1998) · European Journal of Endocrinology · doi:10.1530/eje.0.1380269 · Cited by 320 · see citing works
Menstrual Cyclicity After Metformin Therapy in Polycystic Ovary Syndrome
M, E., Acosta, A., & Mendoza, S. (1997) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(97)00296-2 · Cited by 310 · see citing works
Crave, J. C., Fimbel, S., Lejeune, H., Cugnardey, N., Déchaud, H., & Pugeat, M. (1995) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.80.7.7608255 · Cited by 301 · see citing works
Morin-Papunen, L. C., Koivunen, R. M., Ruokonen, A., & Martikainen, H. K. (1998) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00011-9 · Cited by 283 · see citing works
Koçak, M., Çalışkan, E., ŞİMŞİR, Ç., & Haberal, A. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)02941-7 · Cited by 267 · see citing works
Effects of metformin on gonadotropin-induced ovulation in women with polycystic ovary syndrome
Leo, V. D., Marca, A. L., Ditto, A., Morgante, G., & Cianci, A. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00208-3 · Cited by 266 · see citing works
INSULIN ACTION IN THE NORMAL AND POLYCYSTIC OVARY
Franks, S., Gilling‐Smith, C., Watson, H., & Willis, D. (1999) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(05)70074-8 · Cited by 262 · see citing works
Should Unpublished Data Be Included in Meta-analyses?: Current Convictions and Controversies
Cook, D. J. (1993) · JAMA · doi:10.1001/jama.1993.03500210049030 · Cited by 259 · see citing works
Kolodziejczyk, B., Dulęba, A. J., Spaczyński, R., & Pawelczyk, L. A. (2000) · Fertility and Sterility · doi:10.1016/s0015-0282(00)00501-x · Cited by 252 · see citing works
Ehrmann, D. A. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.82.2.524 · Cited by 251 · see citing works
Glueck, C. J., Wang, P., Fontaine, R. N., Tracy, T., & Sieve-Smith, L. (1999) · Metabolism · doi:10.1016/s0026-0495(99)90113-0 · Cited by 228 · see citing works
Nestler, J. E., Stovall, D. W., Akhter, N., Iuorno, M. J., & Jakubowicz, D. J. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)02963-6 · Cited by 227 · see citing works
Polycystic ovary syndrome--from gynaecological curiosity to multisystem endocrinopathy
Homburg, R. (1996) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a019031 · Cited by 213 · see citing works
Stadtmauer, L., Toma, S. K., Riehl, R. M., & Talbert, L. M. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01766-0 · Cited by 211 · see citing works
Ng, E. H. Y. (2001) · Human Reproduction · doi:10.1093/humrep/16.8.1625 · Cited by 183 · see citing works
Can metformin reduce insulin resistance in polycystic ovary syndrome?
Açbay, Ö., & Gündoğdu, S. (1996) · Fertility and Sterility · doi:10.1016/s0015-0282(16)58266-1 · Cited by 173 · see citing works
Yaralı́, H. (2002) · Human Reproduction · doi:10.1093/humrep/17.2.289 · Cited by 171 · see citing works
Sensitization to Insulin Induces Ovulation in Nonobese Adolescents with Anovulatory Hyperandrogenism
Ibáñez, L., Valls, C., Ferrer, A., Marcos, M. V., Rodriguez-Hierro, F., & de Zegher, F. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.8.7756 · Cited by 162 · see citing works
Hasegawa, I., Murakawa, H., Suzuki, M., Yamamoto, Y., Kurabayashi, T., & Tanaka, K. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00454-3 · Cited by 156 · see citing works
Glueck, C. J., Wang, P., Fontaine, R. N., Tracy, T., & Sieve-Smith, L. (2001) · Journal of Adolescent Health · doi:10.1016/s1054-139x(01)00202-6 · Cited by 153 · see citing works
Nestler, J. E., & Jakubowicz, D. J. (1998) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199805000-00018 · Cited by 135 · see citing works
Insulin resistance and polycystic ovary syndrome
Galluzzo, A., Amato, M. C., & Giordano, C. S. D. S. (2008) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2008.05.004 · Cited by 122 · see citing works
Heard, M., Pierce, A., Carson, S. A., & Buster, J. E. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)03266-6 · Cited by 107 · see citing works
Ünlühızarcı, K., Keleştimur, F., Bayram, F., Şahin, Y., & Tutuş, A. (1999) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1999.00786.x · Cited by 104 · see citing works
Effects of metformin on adrenal steroidogenesis in women with polycystic ovary syndrome
Marca, A. L., Morgante, G., Paglia, T., Ciotta, L., Cianci, A., & Leo, V. D. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00407-0 · Cited by 103 · see citing works
Pirwany, I. R., Yates, R. W. S., Cameron, I., & Fleming, R. (1999) · Human Reproduction · doi:10.1093/humrep/14.12.2963 · Cited by 100 · see citing works
Insulin and the Polycystic Ovary Syndrome
Utiger, R. D. (1996) · New England Journal of Medicine · doi:10.1056/nejm199608293350909 · Cited by 97 · see citing works
Futterweit, W. (1999) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199906000-00024 · Cited by 76 · see citing works
Infertility revisited: The state of the art today and tomorrow
Workshop, T. E. C. (1996) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a019486 · Cited by 67 · see citing works
Insulin Resistance and Polycystic Ovary Syndrome
Potau, N. (2004) · doi:10.1002/0470011327.ch16 · Cited by 53 · see citing works
Parsanezhad, M. E., Alborzi, S., Zarei, A., Dehbashi, S., & Omrani, G. R. (2001) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(01)00470-2 · Cited by 49 · see citing works
Metformin improves ovulation and pregnancy rates in patients with polycystic ovary syndrome
Batukan, C., & Baysal, B. (2001) · Archives of Gynecology and Obstetrics · doi:10.1007/s004040100176 · Cited by 48 · see citing works
Female infertility: Treatment options for complicated cases
Diedrich, K., Collins, J. A., Baird, D. T., Evers, J. L. H., Crosignani, P. G., Tarlatzis, B. C., Cooke, I., Glasier, A. F., Devroey, P., Steirteghem, A. V., et al. (1997) · Human Reproduction · Cited by 43 · see citing works
Clomiphene citrate in the twenty-first century
Nasseri, S., & Ledger, W. J. (2001) · Human Fertility · doi:10.1080/1464727012000199212 · Cited by 40 · see citing works
(1997) · Human Reproduction · doi:10.1093/humrep/12.6.1191 · Cited by 40 · see citing works
Molecular Mechanisms of Insulin Resistance in the Polycystic Ovary Syndrome
Dunaif, A. E. (1994) · Seminars in Reproductive Medicine · doi:10.1055/s-2007-1016376 · Cited by 26 · see citing works
Optimizing ovulation induction in women with polycystic ovary syndrome
Seli, E. U., & Dulęba, A. J. (2002) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/00001703-200206000-00002 · Cited by 23 · see citing works
Prediction of the Effect of Metformin Treatment in Patients with Polycystic Ovary Syndrome
Vrbíková, J., Hill, M., Stárka, L., & Vondra, K. (2002) · Gynecologic and Obstetric Investigation · doi:10.1159/000053002 · Cited by 18 · see citing works
Biochemical and body weight changes with metformin in polycystic ovary syndrome.
Baysal, B., Batukan, M., & Batukan, C. (2001) · PubMed · Cited by 14 · see citing works
Flagged first, then by citations
2 of the 69 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Franks, S. (1997) · Archives of Disease in Childhood · doi:10.1136/adc.77.1.89 · Cited by 802 · see citing works
Tang, T., Lord, J. M., Norman, R. J., Yasmin, E., & Balen, A. H. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub5 · Cited by 698 · see citing works
Metformin in polycystic ovary syndrome: systematic review and meta-analysis
Lord, J. M., Flight, I. H. K., & Norman, R. J. (2003) · BMJ · doi:10.1136/bmj.327.7421.951 · Cited by 786 · see citing works
Jonard, S. (2004) · Human Reproduction Update · doi:10.1093/humupd/dmh010 · Cited by 513 · see citing works
Broekmans, F. J., Knauff, E. A. H., Valkenburg, O., Laven, J. S. E., Eijkemans, M. J. C., & Fauser, B. C. J. M. (2006) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.01008.x · Cited by 445 · see citing works
Palomba, S., Falbo, A., Zullo, F., & Orio, F. (2009) · Endocrine Reviews · doi:10.1210/er.2008-0030 · Cited by 426 · see citing works
Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline
Teede, H. J., Misso, M. L., Deeks, A. A., Moran, L. J., Stuckey, B. G. A., Wong, J. L. A., Norman, R. J., Costello, M. F., & Groups, O. B. O. T. G. D. (2011) · Medical Journal of Australia · doi:10.5694/mja11.10915 · Cited by 379 · see citing works
Self-citationOvulation induction in the management of anovulatory polycystic ovary syndrome
Balen, A. H. (2012) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2012.10.008 · Cited by 337 · see citing works
Naderpoor, N., Shorakae, S., de Courten, B., Misso, M. L., Moran, L. J., & Teede, H. J. (2015) · Human Reproduction Update · doi:10.1093/humupd/dmv025 · Cited by 334 · see citing works
Evidence-based investigations and treatments of recurrent pregnancy loss
Christiansen, O. B., Andersen, A. N., Bosch, E., Daya, S., Delves, P. J., Hviid, T. V. F., Kutteh, W. H., Laird, S. M., Li, T. C., & van der Ven, K. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.12.018 · Cited by 303 · see citing works
Morley, L. C., Tang, T., Yasmin, E., Norman, R. J., & Balen, A. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub6 · Cited by 296 · see citing works
Palomba, S., Orio, F., Falbo, A., Manguso, F., Russo, T., Cascella, T., Tolino, A., Carmina, E., Colao, A., & Zullo, F. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0110 · Cited by 279 · see citing works
Tang, T., Glanville, J., Hayden, C. J., White, D., Barth, J. H., & Balen, A. H. (2006) · Human Reproduction · doi:10.1093/humrep/dei311 · Cited by 335 · see citing works
Naderpoor, N., Shorakae, S., de Courten, B. V., Misso, M. L., Moran, L., & Teede, H. J. (2016) · Human Reproduction Update · doi:10.1093/humupd/dmv063 · Cited by 256 · see citing works
Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome
Tso, L. O., Costello, M., Albuquerque, L. E. T., Andriolo, R. B., & Macedo, C. R. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006105.pub3 · Cited by 255 · see citing works
Self-citationOmbelet, W. U. A. M., Sutter, P. D., Elst, J. V. D., & Martens, G. (2004) · Human Reproduction Update · doi:10.1093/humupd/dmh048 · Cited by 247 · see citing works
Brettenthaler, N., Geyter, C. D., Huber, P., & Keller, U. B. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031737 · Cited by 247 · see citing works
Diamanti‐Kandarakis, E., Christakou, C. D., Kandaraki, E., & Economou, F. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0733 · Cited by 246 · see citing works
The use of metformin for women with PCOS undergoing IVF treatment
Tang, T. H., Glanville, J., Orsi, N. M., Barth, J. H., & Balen, A. H. (2006) · Human Reproduction · doi:10.1093/humrep/del025 · Cited by 215 · see citing works
Costello, M. F., Shrestha, B., Eden, J., Johnson, N., & Moran, L. J. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005552.pub2 · Cited by 197 · see citing works
Self-citationThe polycystic ovary syndrome per se is not associated with increased chronic inflammation
Möhlig, M., Spranger, J., Osterhoff, M., Ristow, M., Pfeiffer, A. F. H., Schill, T., Schlößer, H. W., Brabant, G. E., & Schöfl, C. (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.1500525 · Cited by 182 · see citing works
Penzias, A. S., Bendikson, K. A., Butts, S. F., Coutifaris, C., Falcone, T., Fossum, G., Gitlin, S., Gracia, C. R., Hansen, K. R., LaBarbera, A. R., et al. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.06.026 · Cited by 181 · see citing works
Wang, J. G., Anderson, R. A., Graham, G. M., Chu, M. C., Sauer, M. V., Guarnaccia, M. M., & Løbo, R. A. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.11.082 · Cited by 177 · see citing works
Balen, A. H., & Anderson, R. A. (2007) · Human Fertility · doi:10.1080/14647270701731290 · Cited by 165 · see citing works
Infertility therapy-associated multiple pregnancies (births): an ongoing epidemic
Adashi, E. Y., Barri, P. N., Berkowitz, R. L., Braude, P., Bryan, E. M., Carr, J., Cohen, J. J., Collins, J. A., Devroey, P., Frydman, R., et al. (2003) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)62069-x · Cited by 159 · see citing works
Serum adiponectin levels in women with polycystic ovary syndrome
Panidis, D. (2003) · Human Reproduction · doi:10.1093/humrep/deg353 · Cited by 156 · see citing works
Ganie, M. A., Khurana, M. L., Eunice, M., Gulati, M., Dwivedi, S. N., & Ammini, A. C. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031780 · Cited by 151 · see citing works
Use of Metformin in Polycystic Ovary Syndrome
Creanga, A. A., Bradley, H. M., McCormick, C., & Witkop, C. T. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e31816a4ed4 · Cited by 148 · see citing works
Ovulation induction: a mini review
Messinis, I. E. (2005) · Human Reproduction · doi:10.1093/humrep/dei128 · Cited by 140 · see citing works
Costello, M., Chapman, M., & Conway, U. (2006) · Human Reproduction · doi:10.1093/humrep/dei501 · Cited by 140 · see citing works
Self-citationPalomba, S., Falbo, A. I., Orio, F., & Zullo, F. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.08.087 · Cited by 134 · see citing works
Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome
Sharpe, A., Morley, L. C., Tang, T. H., Norman, R. J., & Balen, A. H. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013505 · Cited by 133 · see citing works
Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review
Costello, M., Shrestha, B., Eden, J., JOHNSON, N. P., & Sjöblom, P. (2007) · Human Reproduction · doi:10.1093/humrep/dem005 · Cited by 132 · see citing works
Self-citationEffects of Rosiglitazone in Obese Women with Polycystic Ovary Syndrome and Severe Insulin Resistance
Sepilian, V., & Nagamani, M. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1376 · Cited by 130 · see citing works
Spranger, J., Möhlig, M., Wegewitz, U. E., Ristow, M., Pfeiffer, A. F. H., Schill, T., Schlösser, H. W., Brabant, G. E., & Schöfl, C. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.02159.x · Cited by 130 · see citing works
Vick, M. M., Sessions, D. R., Murphy, B. A., Kennedy, E. L., Reedy, S. E., & Fitzgerald, B. P. (2006) · Reproduction Fertility and Development · doi:10.1071/rd06016 · Cited by 128 · see citing works
The pathogenesis of infertility and early pregnancy loss in polycystic ovary syndrome
van der Spuy, Z. M., & Dyer, S. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2004.06.001 · Cited by 127 · see citing works
Cussons, A. J., Stuckey, B. G. A., Walsh, J. P., Burke, V., & Norman, R. J. (2005) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.02208.x · Cited by 119 · see citing works
Costello, M., Misso, M. L., Balen, A. H., Boyle, J., Devoto, L., Garad, R. M., Hart, R. J., Johnson, L., Jordan, C., Legro, R. S., et al. (2018) · Human Reproduction Open · doi:10.1093/hropen/hoy021 · Cited by 125 · see citing works
Self-citationAromatase inhibitors for the treatment of infertility
Mitwally, M. F., & Casper, R. F. (2003) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.12.3.353 · Cited by 120 · see citing works
Kort, D. H., & Lobo, R. A. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.05.009 · Cited by 116 · see citing works
Serum resistin levels in women with polycystic ovary syndrome
Panidis, D., Koliakos, G., Kourtis, A., Farmakiotis, D., Mouslech, T., & Rousso, D. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.06.021 · Cited by 103 · see citing works
Tang, T. H., Lord, J. M., Norman, R. J., Yasmin, E., & Balen, A. H. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub4 · Cited by 101 · see citing works
Managing anovulatory infertility and polycystic ovary syndrome
Balen, A. H., & Rutherford, A. J. (2007) · BMJ · doi:10.1136/bmj.39335.462303.80 · Cited by 101 · see citing works
Palomba, S., Pasquali, R., Orio, F., & Nestler, J. E. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03369.x · Cited by 98 · see citing works
Metformin monotherapy in lean women with polycystic ovary syndrome
Kumari, A., Haq, A., Jayasundaram, R., Abdel-Wareth, L., al Haija, S., & Alvares, M. (2005) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)60809-7 · Cited by 96 · see citing works
Nawaz, F. H., Khalid, R., Naru, T. Y., & Rizvi, J. (2008) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2008.00856.x · Cited by 91 · see citing works
Siebert, T. I., Kruger, T. F., Steyn, D. W., & Nosarka, S. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.06.014 · Cited by 91 · see citing works
Biguanides: Species with versatile therapeutic applications
Kathuria, D., Raul, A. D., Wanjari, P. J., & Bharatam, P. V. (2021) · European Journal of Medicinal Chemistry · doi:10.1016/j.ejmech.2021.113378 · Cited by 86 · see citing works
Homburg, R. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2004.05.006 · Cited by 83 · see citing works
Misso, M. L., Costello, M. F., Garrubba, M., Wong, J., Hart, R., Rombauts, L., Melder, A. M., Norman, R. J., & Teede, H. J. (2013) · Human Reproduction Update · doi:10.1093/humupd/dms036 · Cited by 81 · see citing works
Self-citationEndocrine and Metabolic Effects of Rosiglitazone in Non-obese Women with Polycystic Ovary Disease
Dereli, D., Dereli, T., Bayraktar, F., Özgen, G., & Yılmaz, C. (2005) · Endocrine Journal · doi:10.1507/endocrj.52.299 · Cited by 82 · see citing works
Rouzi, A. A., & Ardawi, M. S. M. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.07.1312 · Cited by 80 · see citing works
Zhai, J., Liu, C., Tian, Z.-R., Jiang, Q., & Sun, Y. (2012) · Biology of Reproduction · doi:10.1095/biolreprod.112.099788 · Cited by 77 · see citing works
Maniar, K., Moideen, A., Mittal, A., Patil, A., Chakrabarti, A., & Banerjee, D. (2016) · Pharmacological Research · doi:10.1016/j.phrs.2016.12.003 · Cited by 75 · see citing works
Berstein, L. M., Kvatchevskaya, J. O., Евгеньевна, П. Т., Kovalenko, I. G., Tsyrlina, E. V., Zimarina, T. S., Ourmantcheeva, A. F., Андреевич, А. Л., & Thijssen, J. H. H. (2004) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-004-0587-2 · Cited by 74 · see citing works
Khorram, O., Helliwell, J. P., Katz, S., Bonpane, C. M., & Jaramillo, L. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.10.042 · Cited by 73 · see citing works
Should we continue or stop insulin sensitizing drugs during pregnancy?
Norman, R. J., Wang, J. X., & Hague, W. M. (2004) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/00001703-200406000-00007 · Cited by 71 · see citing works
Mazloomi, S., Sharifi, F., Hajihosseini, R., Kalantari, S., & Mazloomzadeh, S. (2012) · ISRN Endocrinology · doi:10.5402/2012/949427 · Cited by 69 · see citing works
Cataldo, N. A., Abbasi, F., McLaughlin, T., Basina, M., Fechner, P. Y., Giudice, L. C., & Reaven, G. M. (2005) · Human Reproduction · doi:10.1093/humrep/dei289 · Cited by 71 · see citing works
Möhlig, M., Jurgens, A., Spranger, J., Hoffmann, K., Weickert, M. O., Schlösser, H. W., Schill, T., Brabant, G. E., Schüring, A. N., Pfeiffer, A. F. H., et al. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02195 · Cited by 69 · see citing works
Ghazeeri, G. S., Nassar, A. H., Younes, Z. M. H., & Awwad, J. T. (2012) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2012.01385.x · Cited by 66 · see citing works
Tang, T. H., Glanville, J., Hayden, C. J., White, D. M., Barth, J. H., & Balen, A. H. (2006) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000197800.07214.dc · Cited by 65 · see citing works
Zheng, Y., Wang, X.-H., Lai, M.-H., Yao, H., Liu, H., & Ma, H. (2013) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2012.0429 · Cited by 68 · see citing works
Amini, L., Tehranian, N., Movahedin, M., Tehrani, F. R., & Ziaee, S. (2015) · Europe PMC (PubMed Central) · Cited by 61 · see citing works
Ibáñez, L., Valls, C., Cabré, S., & de Zegher, F. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0047 · Cited by 61 · see citing works
Polycystic Ovary Syndrome in the Adolescent
Pfeifer, S. M., & Kives, S. L. (2009) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2008.12.004 · Cited by 60 · see citing works
Polycystic Ovary Syndrome in Adolescents: Challenges in Diagnosis and Treatment
Tehrani, F. R., & Amiri, M. (2019) · Intern J Endocrinol Metab · doi:10.5812/ijem.91554 · Cited by 65 · see citing works
Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome
Checa, M. Á., Requena, A., Salvador, C., Tur, R., Callejo, J., Espinós, J. J., Fábregues, F., Herrero, J. C., & (Reproductive Endocrinology Interest Group of the Spanish Society of Fertility) (2005) · Human Reproduction Update · doi:10.1093/humupd/dmi015 · Cited by 60 · see citing works
Ibáñez, L., & de Zegher, F. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1405 · Cited by 60 · see citing works
Molecularly imprinted solid-phase extraction for the screening of antihyperglycemic biguanides
Feng, S. Y., Lai, E. P. C., Dąbek-Złotorzyńska, E., & Sadeghi, S. (2003) · Journal of Chromatography A · doi:10.1016/j.chroma.2003.11.042 · Cited by 59 · see citing works
Laparoscopic treatment of polycystic ovaries: is it time to relinquish the procedure?
Pirwany, I. R., & Tulandi, T. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00875-6 · Cited by 59 · see citing works
Current and experimental drug therapy for the treatment of polycystic ovarian syndrome
Corte, L. D., Foreste, V., Barra, F., Gustavino, C., Alessandri, F., Centurioni, M. G., Ferrero, S., Bifulco, G., & Giampaolino, P. (2020) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2020.1781815 · Cited by 58 · see citing works
Möhlig, M., Weickert, M. O., Ghadamgadai, E., Machlitt, A., Pfüller, B., Arafat, A. M., Pfeiffer, A. F. H., & Schöfl, C. (2007) · European Journal of Endocrinology · doi:10.1530/eje-07-0102 · Cited by 56 · see citing works
The Role of Insulin-Sensitizing Agents in the Treatment of Polycystic Ovary Syndrome
Katsiki, N., Georgiadou, E., & Hatzitolios, A. I. (2009) · Drugs · doi:10.2165/00003495-200969110-00001 · Cited by 56 · see citing works
Du, Q., Wang, Y.-J., Yang, S., Wu, B., Han, P., & Zhao, Y.-Y. (2012) · Current Medical Research and Opinion · doi:10.1185/03007995.2012.681636 · Cited by 53 · see citing works
Tan, X., Li, S., Chang, Y., Fang, C., Liu, H., Zhang, X., & Wang, Y. (2016) · Clinical and Investigative Medicine · doi:10.25011/cim.v39i4.27091 · Cited by 51 · see citing works
Use of metformin in the treatment of polycystic ovary syndrome
Genazzani, A. D., Ricchieri, F., & Lanzoni, C. (2010) · Women's Health · doi:10.2217/whe.10.43 · Cited by 51 · see citing works
Öner, G., & Müderris, İ. İ. (2011) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2011.07.005 · Cited by 51 · see citing works
Current concepts and novel applications of LH activity in ovarian stimulation
Filicori, M., Cognigni, G. E., Pocognoli, P., Ciampaglia, W., & Bernardi, S. (2003) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(03)00085-7 · Cited by 50 · see citing works
Essah, P. A., Apridonidze, T., Iuorno, M. J., & Nestler, J. E. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.12.036 · Cited by 50 · see citing works
Tang, T. H., Lord, J. M., Norman, R. J., Yasmin, E., & Balen, A. H. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub3 · Cited by 50 · see citing works
Mono-ovulation in women with polycystic ovary syndrome: a clinical review on ovulation induction
Petersen, K. B., Pedersen, N. G., Pedersen, A. T., Lauritsen, M. P., & Freiesleben, N. L. C. (2016) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2016.03.006 · Cited by 48 · see citing works
Yao, K., Bian, C., & Zhao, X. (2017) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2017.4642 · Cited by 48 · see citing works
Patel, R., & Shah, G. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2017.1279597 · Cited by 47 · see citing works
Balen, A. H. (2008) · CRC Press eBooks · doi:10.3109/9781439807224 · Cited by 48 · see citing works
Insulin resistance and metformin in polycystic ovary syndrome
Ben‐Haroush, A., Yogev, Y., & Fisch, B. (2004) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2003.11.027 · Cited by 46 · see citing works
Siebert, T. I., Viola, M. I., Steyn, D. W., & Kruger, T. F. (2012) · Gynecologic and Obstetric Investigation · doi:10.1159/000335253 · Cited by 46 · see citing works
Analysis of clinical characteristics in large-scale Chinese women with polycystic ovary syndrome.
Shi, Y., Guo, M., Yan, J., Sun, W. C., Zhang, X., Geng, L., Xu, L., & Chen, Z. (2007) · PubMed · Cited by 44 · see citing works
Insulin resistance and the long-term consequences of polycystic ovary syndrome
Bhathena, R. K. (2011) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443615.2010.539722 · Cited by 44 · see citing works
Ota, H., Goto, T., Yoshioka, T., & Ohyama, N. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.01.117 · Cited by 43 · see citing works
Wolff, B., Völzke, H., Robinson, D. M., Schwahn, C., Lüdemann, J., Kessler, C., John, U., & Felix, S. B. (2005) · Stroke · doi:10.1161/01.str.0000162712.27799.20 · Cited by 40 · see citing works
Fraison, E., Kostova, E., Moran, L. J., Bilal, S., Ee, C. C., Venetis, C., & Costello, M. F. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005552.pub3 · Cited by 94 · see citing works
Self-citationKar, S., & Sanchita, S. (2015) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.170373 · Cited by 37 · see citing works
Status of clomiphene citrate and metformin for infertility in PCOS
Misso, M. L., Teede, H. J., Hart, R. J., Wong, J., Rombauts, L. J. F., Melder, A., Norman, R. J., & Costello, M. (2012) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2012.07.001 · Cited by 36 · see citing works
Self-citationDasari, P., & Pranahita, G. (2009) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.51337 · Cited by 35 · see citing works
Endometrial Glucose Transporters in Health and Disease
Vrhovac, I., Karin‐Kujundžić, V., Madunić, J., Šola, I. M., & Šerman, L. (2021) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.703671 · Cited by 34 · see citing works
The role of metformin in the management of polycystic ovary syndrome
Tsilchorozidou, T., & Prelević, G. M. (2003) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/00001703-200312000-00005 · Cited by 34 · see citing works
Barba, M., Schünemann, H. J., Sperati, F., Akl, E. A., Musicco, F., Guyatt, G. H., & Muti, P. C. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03459.x · Cited by 34 · see citing works
Möhlig, M., Flöter, A., Spranger, J., Weickert, M. O., Schill, T., Schlößer, H. W., Brabant, G. E., Pfeiffer, A. F. H., Selbig, J., & Schöfl, C. (2006) · Diabetologia · doi:10.1007/s00125-006-0395-0 · Cited by 34 · see citing works
- Authors
- Costello, M. F., & Eden, J. A.
- Affiliations
- Royal Hospital for Women (AU)
- Corresponding author
- Costello, Michael F
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2003-01
- Volume
- 79
- Issue
- 1
- Pages
- 1-13
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2026898125
- Cited by
- 224
- References
- 69
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 6 · 2020: 4 · 2019: 8 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 4 · 2013: 7 · 2012: 18
- FWCI
- 5.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- metformin, polycystic ovary syndrome, ovulation induction, clomiphene citrate, gonadotropin injection, in vitro fertilization, anovulatory infertility, menstrual cycle restoration, pregnancy rate, follicle-stimulating hormone, obesity
- MeSH terms
- Clomiphene, Drug Therapy, Combination, Female, Fertilization in Vitro, Follicle Stimulating Hormone, Humans, Infertility, Female, Metformin, Ovulation Induction, Polycystic Ovary Syndrome, Pregnancy, Randomized Controlled Trials as Topic, MEDLINE
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
