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Metformin pregnancy

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https://www.readbyqxmd.com/read/28244019/effect-of-metformin-and-oral-contraceptives-on-polycystic-ovary-syndrome-and-ivf-cycles
#1
M N Kalem, Z Kalem, T Gurgan
AIM: The aim of this study is to investigate the effect of metformin and/or OC added to the treatment of PCOS patients at our clinic on IVF outcome. MATERIALS AND METHODS: This study is a retrospective study that assesses the data of PCOS patients who received IVF between 2005 and 2015 at a private IVF center. The study included 496 PCOS cases aged between 24 and 40. Participants diagnosed with PCOS were divided into 4 groups according to the use of metformin and OC prior to the IVF cycle: 11...
February 27, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28236849/should-metformin-be-included-in-fertility-treatment-of-pcos-patients
#2
Jigal Haas, Yaakov Bentov
Metformin, a drug developed for the treatment of patients with type II diabetes, has become commonly prescribed medication for PCOS patients. Initially, metformin was prescribed for patients with impaired glucose tolerance at the pre conception period, however more recently its use was expanded to many of the PCOS patients and for the whole duration of pregnancy. Several studies examining the effects of Metformin during pregnancy reported a lower pregnancy loss, reduced gestational diabetes and no increased risk for birth defects, however, several more recent studies also raised concerns about its safe use...
March 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28193233/tacrolimus-in-the-prevention-of-adverse-pregnancy-outcomes-and-diabetes-associated-embryopathies-in-obese-and-diabetic-mice
#3
Ahmad J H Albaghdadi, Melanie A Hewitt, Samantha M Putos, Michael Wells, Terence R S Ozolinš, Frederick W K Kan
BACKGROUND: T2DM is a high-risk pregnancy with adverse fetal and maternal outcomes including repeated miscarriages and fetal malformations. Despite the established association between placental insufficiency and poor maternal Th1-adaptability to the development of pregnancy complications in T2DM, there have been no established data to assess benefits of pre-pregnancy immunosuppression relative to gestational outcomes in T2DM. We hypothesized that pre-pregnancy macrolide immune suppression can re-establish normal placental development and uterine vascular adaptation in a mouse model of obesity-associated T2DM...
February 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28179448/the-igf-system-in-patients-with-type-2-diabetes-associations-with-markers-of-cardiovascular-target-organ-damage
#4
Rikke Hjortebjerg, Esben Laugesen, Pernille Høyem, Claus Oxvig, Brian Stausbøl-Grøn, Søren T Knudsen, Won Y Kim, Per L Poulsen, Troels K Hansen, Mette Bjerre, Jan Frystyk
OBJECTIVE: Perturbations in the insulin-like growth factor (IGF) system may contribute to the accelerated cardiovascular disease (CVD) that occurs in patients with type 2 diabetes (T2D). However, it remains unknown whether the IGF system is also involved in the development of early, subclinical CVD. We characterised the IGF system in T2D patients and matched controls and examined the associations with markers of subclinical target organ damage. METHODS: The study included 99 patients with recently diagnosed T2D and 99 age- and sex-matched controls...
May 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28143834/treatment-strategies-for-women-with-who-group-ii-anovulation-systematic-review-and-network-meta-analysis
#5
Rui Wang, Bobae V Kim, Madelon van Wely, Neil P Johnson, Michael F Costello, Hanwang Zhang, Ernest Hung Yu Ng, Richard S Legro, Siladitya Bhattacharya, Robert J Norman, Ben Willem J Mol
OBJECTIVE:  To compare the effectiveness of alternative first line treatment options for women with WHO group II anovulation wishing to conceive. DESIGN:  Systematic review and network meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Medline, and Embase, up to 11 April 2016. STUDY SELECTION:  Randomised controlled trials comparing eight ovulation induction treatments in women with WHO group II anovulation: clomiphene, letrozole, metformin, clomiphene and metformin combined, tamoxifen, gonadotropins, laparoscopic ovarian drilling, and placebo or no treatment...
January 31, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28127850/the-emerging-role-of-metformin-in-gestational-diabetes-mellitus
#6
REVIEW
Susan G Gray, Treasure McGuire, Neale Cohen, Peter J Little
Metformin use during pregnancy is controversial and there is disparity in the acceptance of metformin treatment in women with gestational diabetes mellitus (GDM) in Australia. Despite short term maternal and neonatal safety, the placental transfer of metformin during GDM treatment and absence of long term safety data in offspring has regulators and prescribers cautious about its use. To determine the current role in GDM management, this literature review describes the physiological changes that occur in GDM and other forms of diabetes in pregnancy (DIP), and international changes in guidelines for GDM diagnosis...
January 27, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28120427/oral-anti-diabetic-pharmacological-therapies-for-the-treatment-of-women-with-gestational-diabetes
#7
REVIEW
Julie Brown, Ruth Martis, Brenda Hughes, Janet Rowan, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health issue with rates increasing globally. Gestational diabetes, glucose intolerance first recognised during pregnancy, usually resolves after birth and is associated with short- and long-term complications for the mother and her infant. Treatment options can include oral anti-diabetic pharmacological therapies. OBJECTIVES: To evaluate the effects of oral anti-diabetic pharmacological therapies for treating women with GDM...
January 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28118681/metformin-during-ovulation-induction-with-gonadotrophins-followed-by-timed-intercourse-or-intrauterine-insemination-for-subfertility-associated-with-polycystic-ovary-syndrome
#8
REVIEW
Esmée M Bordewijk, Marleen Nahuis, Michael F Costello, Fulco Van der Veen, Leopoldo O Tso, Ben Willem J Mol, Madelon van Wely
BACKGROUND: Clomiphene citrate (CC) is generally considered first-line treatment in women with anovulation due to polycystic ovary syndrome (PCOS). Ovulation induction with follicle-stimulating hormone (FSH; gonadotrophins) is second-line treatment for women who do not ovulate or conceive while taking CC. Metformin may increase the effectiveness of ovulation induction with gonadotrophins and may promote safety by preventing multiple pregnancy. OBJECTIVES: To determine the effectiveness and safety of metformin co-treatment during ovulation induction with gonadotrophins with respect to rates of live birth and multiple pregnancy in women with PCOS...
January 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28111738/interventions-for-the-prevention-of-ohss-in-art-cycles-an-overview-of-cochrane-reviews
#9
REVIEW
Selma Mourad, Julie Brown, Cindy Farquhar
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technology (ART) cycles is a treatment-induced disease that has an estimated prevalence of 20% to 33% in its mild form and 3% to 8% in its moderate or severe form. These numbers might even be higher for high-risk women such as those with polycystic ovaries or a high oocyte yield from ovum pickup. OBJECTIVES: The objective of this overview is to identify and summarise all evidence from Cochrane systematic reviews on interventions for prevention or treatment of moderate, severe and overall OHSS in couples with subfertility who are undergoing ART cycles...
January 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28069720/pregnancy-increases-the-renal-secretion-of-n1-methylnicotinamide-an-endogenous-probe-for-renal-cation-transporters-in-patients-prescribed-metformin
#10
Mackenzie C Bergagnini-Kolev, Mary F Hebert, Thomas R Easterling, Yvonne S Lin
N1-methylnicotinamide (1-NMN) has been investigated as an endogenous probe for the renal transporter activity of organic cation transporter 2 (OCT2) and multidrug and toxin extrusion proteins 1 and 2-K (MATE1 and MATE2-K). As pregnancy increased the renal secretion of metformin, a substrate for OCT2, MATE1 and MATE2-K, we hypothesized that the renal secretion of 1-NMN would be similarly affected. Blood and urine samples collected from women prescribed metformin for type 2 diabetes, gestational diabetes and polycystic ovarian syndrome (PCOS) during early-, mid-, and late-pregnancy (n = 34 visits) and postpartum (n=14 visits) were analyzed for 1-NMN using liquid chromatography-mass spectrometry...
January 9, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28042411/clomiphene-citrate-treatment-cycle-outcomes-of-polycystic-ovary-syndrome-patients-based-on-basal-high-sensitive-c-reactive-protein-levels-a-cross-sectional-study
#11
Serkan Kahyaoglu, Omer Hamid Yumuşak, Sebnem Ozyer, Meryem Kuru Pekcan, Merve Erel, Mahmut Nedim Cicek, Salim Erkaya, Yasemin Tasci
BACKGROUND: Polycystic ovary syndrome (PCOS) is highly associated with an ovulatory infertility, features of the metabolic syndrome, including obesity, insulin resistance and dyslipidemia. Serum concentrations of high sensitive C-reactive protein (hs-CRP) were significantly higher in obese than in non-obese PCOS patients at baseline, suggesting a relationship between elevated hs-CRP levels and obesity. The aim of this study was to evaluate whether cycle day 3 hs-CRP levels before clomiphene citrate (CC) treatment would predict cycle outcomes in women with PCOS...
January 2017: International Journal of Fertility & Sterility
https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#12
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27917777/the-identification-and-treatment-of-women-with-hyperglycaemia-in-pregnancy-an-analysis-of-individual-participant-data-systematic-reviews-meta-analyses-and-an-economic-evaluation
#13
Diane Farrar, Mark Simmonds, Susan Griffin, Ana Duarte, Debbie A Lawlor, Mark Sculpher, Lesley Fairley, Su Golder, Derek Tuffnell, Martin Bland, Fidelma Dunne, Donald Whitelaw, John Wright, Trevor A Sheldon
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a higher risk of important adverse outcomes. Practice varies and the best strategy for identifying and treating GDM is unclear. AIM: To estimate the clinical effectiveness and cost-effectiveness of strategies for identifying and treating women with GDM. METHODS: We analysed individual participant data (IPD) from birth cohorts and conducted systematic reviews to estimate the association of maternal glucose levels with adverse perinatal outcomes; GDM prevalence; maternal characteristics/risk factors for GDM; and the effectiveness and costs of treatments...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27871268/metformin-and-dietary-advice-to-improve-insulin-sensitivity-and-promote-gestational-restriction-of-weight-among-pregnant-women-who-are-overweight-or-obese-the-grow-randomised-trial
#14
Jodie M Dodd, Rosalie M Grivell, Andrea R Deussen, Gustaaf Dekker, Jennie Louise, William Hague
BACKGROUND: Obesity is a significant global health problem, with approximately 50% of women entering pregnancy having a body mass index greater than or equal to 25 kg/m(2). Obesity during pregnancy is associated with a well-recognised increased risk of adverse health outcomes both for the woman and her infant. Currently available data from large scale randomised trials and systematic reviews highlight only modest effects of antenatal dietary and lifestyle interventions in limiting gestational weight gain, with little impact on clinically relevant pregnancy outcomes...
November 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27866938/ovulation-induction-in-polycystic-ovary-syndrome-current-options
#15
REVIEW
Richard S Legro
There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-pituitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed toward replacing clomiphene, a selective estrogen receptor modulator, as the first-choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin); further studies are needed of newer agents to treat type 2 diabetes...
November 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27824743/managing-recurring-obstetric-cholestasis-with-metformin
#16
Abdullatif Elfituri, Amanda Ali, Hassan Shehata
BACKGROUND: Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus. CASE: This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27816925/a-short-course-of-metformin-does-not-reduce-ohss-in-a-gnrh-antagonist-cycle-for-women-with-pcos-undergoing-ivf-a-randomised-placebo-controlled-trial
#17
S L Jacob, C Brewer, T Tang, H M Picton, J H Barth, A H Balen
STUDY QUESTION: Does 'metformin' reduce the incidence of ovarian hyperstimulation syndrome (OHSS) for women with polycystic ovary syndrome (PCOS) undergoing a GnRH antagonist assisted conception treatment cycle? SUMMARY ANSWER: A short course of metformin does not reduce the incidence of OHSS for women with PCOS undergoing a GnRH antagonist treatment cycle. WHAT IS KNOWN ALREADY: Metformin does reduce the incidence of OHSS in a GnRH-agonist treatment cycle...
November 5, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27806559/investigation-the-effects-of-metformin-versus-insulin-on-neonatal-and-maternal-outcomes-in-women-with-gestational-diabetes-mellitus-a-randomized-clinical-trail
#18
Mahin Najafian, Mojgan Barati, Sara Masihi, Ailin Fardipor
The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies...
September 28, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27752931/pharmacological-management-of-gestational-diabetes-mellitus
#19
REVIEW
Riki Bergel, Eran Hadar, Yoel Toledano, Moshe Hod
Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy...
November 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27687080/natural-selection-the-evolution-of-diagnostic-criteria-for-gestational-diabetes
#20
REVIEW
Claire L Meek
Gestational diabetes is a common pregnancy disorder which is generally managed with diet, exercise, metformin or insulin treatment and which usually resolves after delivery of the infant. Identifying and treating gestational diabetes improves maternal and fetal outcomes and allows for health promotion to reduce the mother's risk of type 2 diabetes in later life. However, there remains considerable controversy about the optimal method of identification and diagnosis of women with gestational diabetes. The NICE-2015 diagnostic criteria (75 g oral glucose tolerance test (OGTT) 0 h ≥5...
January 2017: Annals of Clinical Biochemistry
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