Endocrine Abstracts

Insulin resistance and its resultant hyperinsulinaemia seem to play a pivotal role in the pathogenesis of polycystic ovary syndrome (PCOS), which apart from its cosmetic and metabolic consequences also lead to fertility problems. Therefore, metformin – a biguanide used as the first line of pharmacotherapy in patients with type 2 diabetes mellitus (T2DM), is often prescribed to women with PCOS in order to decrease the consequences of hyperinsulinaemia and to restore ovulation. Nevertheless, the efficacy of metformin in restoring fertility in unovulatory women with PCOS remains questionable and according to the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group its routine use for this indication is not recommended. In contrary, life-style interventions including dietary treatment and the implementation of physical activity seems to be very effective in restoring fertility in obese women with PCOS, however large well controlled randomized studies are still warranted.