PCOS Messages for November, 2000: Re: Met vs Miscarriage

Re: Met vs Miscarriage

From: Elizabeth (anonymous@obgyn.net)
Wed, 29 Nov 2000 12:05:36 -0800 (PST)

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Thanks soooo much for sharing this with us! It is greatly appreciated. Diane < >
--- anonymous@obgyn.net wrote: > This is a news story that might be of interest:
> The following news story is from Reuters News
> Service
>
> Metformin reduces miscarriages in women
> with polycystic ovary
> syndrome
>
> SAN DIEGO, CA, Apr 19 (Reuters Health) -
> Metformin therapy reduces the risk of
> miscarriages in women with polycystic ovary
> syndrome (PCOS) by reducing levels of
> plasminogen activator inhibitor, according
> to a presentation made here this week at the
> Experimental Biology 2000 meeting.
>
> Dr. Charles Glueck of Jewish Hospital,
> Cincinnati, Ohio, said that he has found that
> metformin reduces the first-trimester
> miscarriage rate from 45% to 9%, with 9% to 13%
> being the US average.
>
> Now his group has discovered that the
> miscarriage rate is so high because, in addition to
> high insulin levels and an abundance of
> male sex hormones, women with PCOS have high
> levels of plasminogen activator inhibitor,
> which causes placental blood clots. Metformin
> reduces the risk of miscarriage by reducing
> plasminogen activator inhibitor levels, Dr.
> Glueck said.
>
> Noting that "there's no other biologic
> system that we know of that fails 13% of the time in
> healthy people," he said that he and his
> colleagues determined that many miscarriages
> are due to abnormalities in placental blood
> clotting. Women who are homozygous for a
> particular version of the plasminogen
> activator inhibitor gene or who have inherited
> coagulation disorders are at particular
> risk.
>
> "Once you know that in a woman who's had a
> miscarriage, then you can identify the
> genetic disorder and treat with
> low-molecular-weight heparin throughout the
> pregnancy,"
> Dr. Glueck said. His group is recommending
> that all women be tested for coagulation
> ability before conception. "We suspect we
> could identify women prone to miscarriage," he
> said.
>
> He noted that a year's supply of metformin
> would cost about $700, while fertility
> treatments, which are ineffective for PCOS,
> cost about $30,000 and are not covered by
> insurance.
>
> Noting that metformin induced an average
> weight loss of 16 kg in women with PCOS, Dr.
> Glueck's group also examined the ability of
> metformin to induce weight loss in 22 morbidly
> obese men and women who had significant
> insulin resistance but were not diabetic. In an
> open-label study, they treated patients
> with metformin daily for 24 weeks without any
> change in their regular diet.
>
> Metformin caused a 6% weight loss and
> reduced weight and hip circumference by 3
> inches. The fasting insulin also fell from
> high to normal levels, and surprisingly, levels of
> low-density lipoprotein cholesterol also
> fell significantly. Treatment with metformin may
> prevent the development of type 2 diabetes
> in these patients, Dr. Glueck said.
>
> -Westport Newsroom 203 319 2700
>
> © 2000 Reuters Limited. All rights
> reserved. Republication or redistribution of Reuters
> content, including by
> framing or similar means, is expressly
> prohibited without the prior written consent of
> Reuters. Reuters shall
> not be liable for any errors or delays in
> the content, or for any actions taken in reliance
> thereon.
>

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