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"metformin + FSHr" is a combination treatment regimen consisting of the insulin-sensitizing small molecule metformin and recombinant follicle-stimulating hormone (FSHr). This regimen is primarily investigated for the treatment of infertility in women with clomiphene-resistant polycystic ovary syndrome (PCOS). Metformin acts by activating AMP-activated protein kinase (AMPK), which improves insulin sensitivity and reduces androgen production in the ovaries. Recombinant FSH (such as follitropin alfa) acts as an agonist at the follicle-stimulating hormone receptor (FSHR) on granulosa cells to stimulate follicular development and maturation. In the PERCING clinical trial (NCT00378729), this combination was used as part of an ovarian stimulation and intrauterine insemination (IUI) protocol to compare its efficacy against surgical laparoscopic ovarian drilling.
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