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Abstract
Evaluate the effect of metformin on serum insulin (fasting and 2hr postprandial), androgens (total and free testosterone, DHEAS and SHBG) and AMH in PCOS patients at 3 and 6 months interval. Prospective study. Kasr Alaini university hospital, obstetrics and gynecology department. 50 hyperandrogenic PCOS patients. Interventions: 1700 mg metformin was given for a period of 6 months; serum insulin, previously mentioned androgens and AMH were measured at baseline, 3 months and 6 months of treatment. Serum fasting and 2 hrs. postprandial insulin and glucose levels, insulin resistance, serum total and free testosterone, DHEAS and SHBG and serum AMH. The impact of treatment and biochemical changes on menstrual regularity, clinical manifestations of hyperandrogenism, ovarian morphology and fertility. Effects of Metformin on serum Insulin, anti - mullerian hormone and on androgen levels in patients with PCOS viii. Metformin treatment produced a significant reduction in insulin, serum androgens and AMH levels. 62% of the patients had improvement in their cycle regularity and 2 out of 50 patients had spontaneous pregnancy. However, there were no improvement in hyperandrogenic manifestations or change in ovarian morphology. Metformin as an insulin sensitizing agent improved insulin resistance in PCOS patients and improved biochemical but not clinical hyperandrogenism. Metformin produced significant reduction in AMH levels and modest improvement in cycle regularity; but no change in the ovarian morphology. Metformin could not be used for the treatment of hirsutism or in improving fertility in PCOS