By reducing blood levels of insulin, metformin (Glucophage), a medication commonly prescribed for diabetes, has been shown to induce ovulation in patients with polycystic ovarian syndrome (PCOS). Insulin, directly or indirectly, stimulates ovarian production of male hormones, which interfere with ovulation. Reduction of insulin results in decreased male hormone production and either ovulation or reduction in the need for high doses of clomiphene. Metformin is given at doses of 500 to 2500 mg daily, either alone or in conjunction with clomiphene or injectable gonadotropins. To reduce side effects, metformin dose should be increased gradually over several weeks.

Indications:
Patients with chronic anovulation, especially patients with elevated male hormones (PCOS), may benefit most from metformin.

Contraindications and adverse effects:
Nausea and diarrhea are very common, usually decreasing with longer use. A serious complication called lactic acidosis may occur in patients with damaged kidneys or patients suffering from vomiting from unrelated causes (e.g. infection, pregnancy). In patients who are not diabetic, metformin rarely results in low blood sugar.  Modest weight loss may occur with metformin, though it is not a weight-loss medication.

METFORMIN IS NOT APPROVED AT PRESENT BY THE FDA FOR OVULATION INDUCTION. PLEASE DISCUSS ITS USE WITH YOUR FERTILITY SPECIALIST.