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العنوان
THE ROLE OF METFORMIN IN PREVENTION OF FIRST TRIMESTERIC MISCARRIAGE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME :
المؤلف
Dabbous, Islam Hussein Ezzat.
هيئة الاعداد
باحث / إسلام حسين عزت دبوس
مشرف / حسن عواد بيومي
مشرف / أحمد عبد الشافي الشهاوي
مناقش / حسن عواد بيومي
تاريخ النشر
2019.
عدد الصفحات
151 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض النساء والتوليد
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - أمراض النساء و التوليد
الفهرس
Only 14 pages are availabe for public view

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Abstract

Women with insulin resistance are at increased risk of hyperinsulinemia, PCOS, and hyperandrogenism. They are also at risk of reduced fertility due to ovulatory dysfunction and suboptimal hormonal profiles that may impair conception and implantation.
This emphasizes the need for a treatment using drugs such as metformin, which will actively reduce insulin resistance, and will restore ovulatory cycles and reduce early pregnancy loss. In addition to this there is accumulating evidence suggesting that this drug is probably safe in the first trimester of pregnancy despite the traditional response that all oral hypoglycemic agents are contraindicated in pregnancy.
The findings of this study support the previous reports that stated that decreasing insulin resistance with metformin in women with PCOS decreases the rate of early pregnancy loss.
In our analysis, it is observed that there was a dramatic reduction in the rates of early pregnancy loss in the metformin group compared with the control group. The early pregnancy loss rate of 10.8% is comparable to the rate of 10 – 20% repoted in normal women. While in the control group early pregnancy loss rate was 42.2%.
It is reported that the beneficial role of metformin is independent of its hypoglycemic activity but occurs through the effect on lipid, inflammation, hemostasis, endothelial cells, and platelet function.
In addition to these, there are several mechanisms for the action of this drug in patients with PCOS.
One major effect is brought about by the reduction of the hyperandrogenization of the embryo. In addition to the effect of immunoglobulin G-binding protein, which seems to facilitate the adhesion process at the endometrial interface.
An analysis of the effects of BMI in both groups of patients shows that although the mean BMI was not significantly different, high BMI was associated with a higher rate of early pregnancy loss. These observations may be explained by the adverse effect of high insulin resistance, which is more prominent with high BMI.
Nausea and mild gastrointestinal symptoms are the most frequent side effects of metformin treatment. It was anticipated that this treatment might exaggerate the morning sickness of pregnancy. However, it was well tolerated in all patients, with no serious complications.