TITLE:
Effect of Metformin on Endometrial Thickness and Subendometrial Flow Patterns in Anovulatory Patients with Polycystic Ovarian Syndrome
AUTHORS:
Waleed M. Khalaf, Sherif A. Akl, Rania R. Ramadan
KEYWORDS:
Endometrial Thickness, Subendometrial Flow Patterns, Anovulatory PCOS, Metformin
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.14,
December
4,
2018
ABSTRACT: Background: Polycystic ovarian syndrome (PCOS) is considered the commonest
endocrinological disorder affecting reproductive aged women. PCOS compromises
fertility through various pathways. These pathways include hyperandrogenism,
insulin resistance and impedance of the uterine and endometrial blood flow.
Metformin improves the blood flow to the endometrium. It acts by reducing
androgen level and correction of insulin resistance. Endometrial vascular
indices were evaluated in this study to evaluate endometrial receptivity in
anovulatory patients with PCOS. Aim of the Work: To evaluate the outcome
of metformin administration in anovulatory patients with PCOS and its effect on
the endometrium. This included its role in ovulation and improvement of
pregnancy rates. Patients and Methods: This study included 85 patients
from Ain Shams University outpatient infertility clinics from 1st of
January, 2018 till 30th of June, 2018. We investigated these
patients before treatment with ultrasound on day 14, 21. We evaluated
endometrial thickness, uterine artery flow pattern, endometrial and
subendometrial flow patterns. The patients received metformin 500 mg three
times per day for three months. After this duration, we reevaluated them by
ultrasound at days 14, 21. Results: Metformin therapy resulted in a
significant increase of endometrial thickness and had a significant decrease on
uterine, endometrial and subendometrial resistance index (R.I) and pulsatility
index (P.I) at day 14, 21 compared to pre-treatment values indicating better
blood flow. Conclusion: Metformin therapy resulted in improvement of
endometrial flow patterns. Also, it resulted in increase in endometrial
thickness and improvement of uterine artery flow.