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Conventional IVF
Gonadotrophin hCG OR ET
GnRH agonist
progesterone
0 7 14 21 28 35 42 49 56 63
Starting dose 75 – 150 units hMG or FSH, if predicted high response
Monitor with ultrasound + biochemistry
Kwan et al, Cochrane 2014; CD005289
Metformin in patients with PCOS undergoing IVF
Short term metformin 850mg bd, 4 weeks Long GnRH agonist protocol
101 randomised: 52 metformin vs 49 placebo
Improved LBR in subsequent FET cycles: 28.6 vs 12.3% (P < 0.01)
Tang, et al, Hum Reprod 2006; 6:1416 Brewer et al, Hum Fertil 2010; 13: 134 Morley et al, Cochrane 2017
MET
PLA
p
Live birth rate / cycle (%) (beyond 24 weeks)
32.7
12.2
0.027
Live birth rate / transfer (%) (beyond 24 weeks)
37.8
14.3
0.025
% of severe OHSS
3.8
20.4
0.023
Page 126 of 196
PRECONGRESS COURSE 07 I BARCELONA, SPAIN – 1 JULY 2018 133
