metformin + gonadotropins

Metformin + gonadotropins is a combination therapy used primarily in the treatment of infertility, especially in women with polycystic ovary syndrome (PCOS) who are resistant to first-line ovulation induction agents. Metformin is an oral insulin sensitizer that lowers hepatic glucose production and improves peripheral insulin sensitivity, thereby reducing hyperinsulinemia and androgen levels. Gonadotropins (such as recombinant or purified follicle-stimulating hormone, FSH) are injectable hormones that directly stimulate ovarian follicular development and induce ovulation. The combination aims to improve ovulatory response rates, increase live birth rates, and potentially reduce the risk of multiple pregnancies compared to gonadotropin therapy alone. Mechanistically, metformin acts via activation of adenosine monophosphate-activated protein kinase (AMPK), which can modulate reproductive hormone secretion at both central (pituitary) and peripheral levels[1][4][5]. This regimen is typically considered for women with PCOS who have not responded adequately to clomiphene citrate or letrozole.

Other names

metformin and step-down gonadotropinsmetformin plus gonadotropins