Is Metformin The Best Option for Getting Pregnant with PCOS?
Hello all you wonderful people viewing this through your computer screen or mobile device! I apologize for my lack of recent postings, I will be coming back with a vengeance don't you worry! Lots of new topics up my virtual sleeve :) I was doing some research and I had to share this with you. I came across an article on Google News: Pregnancy rate doubles with exenatide vs. metformin in PCOS.
Here are the main findings of the article:
'The rate of natural pregnancy was higher following exenatide therapy vs. metformin (43.6% vs. 18.7%), according to researchers. Menstrual cycle also became more regular in both groups, with greater improvement observed in those assigned exenatide (P <.001). The most frequent adverse events reported were mild or moderate gastrointestinal discomfort. The fact that subjects lost more weight with EXE may partly explain why the participants in the EXE group had more regular menstrual cycles than those in the MET group.'
Most of us have heard of Metformin, or heck, have been on it for years at this point. However, this is one of the first times that I’d heard of exenatide therapy. Because of the awesome results of the therapy listed in the article - the higher rate of natural pregnancy, cycle regularity, and weight loss - I wanted to talk a bit more about it here.
Exenatide therapy is similar to Metformin in that it helps improve glycemic control, and therefore, combats insulin resistance. While Metformin is an oral anti-diabetic (known as a Biguanide) that works to decrease the production of glucose in the liver, Exenatide therapy (often marketed under the tradenames Bydureon, Victoza, or Byetta) is administered as a weekly injection.
These types of drugs are called GLP-1 receptor agonists (agonist just means something that causes a response in the body when it is combined with a receptor (receptor is usually a site where a protein, hormone, or neurotransmitter can sit to activate a response elsewhere in the body)), which mimic the effect of glucagonlike peptide- 1, a hormone that increases insulin production when blood sugar is high (Sorry guys, I'm a science nerd and I love human physiology. Don't hold it against me). So in essence, the drug mimics this hormone (called GLP-1) and causes the body to produce more insulin (increased satiety -feeling full- was also reported).
[2024 update: I wrote this article in 2017 before GLP-1 receptor agonists were all the rage. DOING YOUR RESEARCH PAYS OFF LADIES! In case you haven’t realized what I’m on about yet…do you know what else is a GLP-1 receptor agonist? SEMAGLUTIDE (aka Ozempic)! These drugs (GLP-1 receptor agonists) are not all structurally the same, but, this is why I am such a big advocate of staying informed about research. The more you know about it, the more you can advocate for YOURSELF as the patient to ensure you are getting the best care.]
Fun fact, exenatide itself is a hormone that is derived from the Gila Monster. If you don't know what this is, it's a big-ass lizard found in the Southwest US and Mexico. Kind of weird, kind of cool, kind of gross. I have mixed feelings....I've included a few pictures of the Gila Monster below for your viewing pleasure. It's eyes are staring into your soul.....
Feel free to read the whole article and do a little more research on the topic yourself. Or, if you have any questions or comments...feel free to ask below!
You can view the article here.
Resources
American Diabetes Association. Pharmacologic approaches to Glycemic Treatment. Diabetes Care 2017 Jan; 40(Supplement 1): S64-S74. https://doi.org/10.2337/dc17-S011Liu X, et al. Pregnancy rate doubles with exenatide vs. metformin in PCOS. Clin Endocrinol. 2017;doi:10.1111/cen.13454.