Monday, April 17, 2000
Diabetes drug may fight infertility
Local researcher finds metformin cuts miscarriages
BY Tim Bonfield
The Cincinnati Enquirer
Five-month-old Audrey Jacobs is the second child her mother thought she'd never have.
Five-month-old Audrey arrived after her mother, Jackie Jacobs, began taking the diabetes drug metformin.
(Glenn Hartong photo)
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Audrey was born Nov. 5 after treatment with a common diabetes drug apparently reversed years of fertility problems suffered by her mother, Jackie Jacobs of Owensville.
“Everything is fine. She's healthy and happy. She's beautiful,” Mrs. Jacobs said.
Mrs. Jacobs has polycystic ovary syndrome, an inherited condition that affects as many as one in 17 American women. Many women with PCOS do not ovulate at all, making conception impossible. Those who do get pregnant often have miscarriages.
Today in San Diego, at a national experimental biology conference, Cincinnati researcher Dr. Charles Glueck is scheduled to present findings that the diabetes drug metformin, also known as glucophage, can sharply reduce the miscarriage rate among women with polycystic ovary syndrome.
In a study of 118 women with the syndrome, 23 got pregnant while taking metformin and 36 got pregnant without the drug. However, the miscarriage rate for the women taking the drug was 9 percent, compared with 45 percent for those who did not.
The findings are significant, Dr. Glueck said, because the treatment could reduce the anguish of mis carriage while possibly saving some couples thousands of dollars in often unsuccessful fertility treatments.
According to Dr. Glueck, PCOS is closely linked to another condition called insulin resistance syndrome.
In some people, the pancreas must pump out five to 10 times as much insulin as normal to control glucose levels in the body. In women, this excessive insulin production also triggers excessive levels of male hormones.
This hormone imbalance can lead to a lack of ovulation, unwanted hair on the face and chest, severe obesity, high cholesterol levels, high blood pressure, and an inability to dissolve blood clots. By age 50, most women with PCOS wind up with type II diabetes.
Dr. Glueck said the metformin treatment can reduce all these problems.
Mrs. Jacobs, 30, said she wasn't diagnosed with polycystic ovary syndrome until after she started fertility treatments.
She and her husband, Eric, started trying to have children about five years ago. Several months of fertility treatments did lead to their first child, Nathan, who was born three years ago.
Later, the Jacobses tried for a second child. Months of fertility treatments, resulted in a pregnancy that ended with a miscarriage.
It was during this second effort that doctors diagnosed her condition. After hearing about Dr. Glueck's research from a local television report, she looked him up.
Within a month of taking the diabetes drug, she got pregnant with Audrey without any other medical assistance. Now, the couple wonders if they ever needed the fertility treatments that cost them several thousand dollars.
“One of my (obstetric) doctors was familiar with Dr. Glueck, but said that treatment wasn't for someone like me. Since that time, my ob docs have changed their tune,” Mrs. Jacobs said.
While the drug apparently helped Mrs. Jacobs, how many other infertile couples could benefit from the treatment remains unclear. That's because many factors other than PCOS influence infertility, specialists say.
Dr. Glueck's findings appear dramatic and interesting, said Dr. NeeOo Chin, a Tristate fertility specialist. But it remains difficult to project how much of an impact the treatment might have.
“More follow-up studies need to be done,” Dr. Chin said “It will be interesting to see if those results hold up in larger trials.”
While many fertility specialists have begun to recognize metformin's beneficial effects at restoring ovulation in women with PCOS, the finding that the drug also can help prevent miscarriages is a big leap, said Dr. Glen Hofmann, medical director of the Bethesda Center for Reproductive Health and Fertility.
“Metformin is a great drug. I use it for a lot of my patients,” Dr. Hofmann said. “But I don't want the public to think this is a magic bullet for preventing miscarriages. He may be onto something, but right now, I don't see the data to support it.”
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