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Metformin Use In IVF Patients

 

Please describe the patients who will receive Metformin in your unit
  • All obese patients
  • Obese with anovulation (PCOD)
  • All patients with anovulation
  • Patients with glucose intolerance and insulin resistance
  • All of the above
  • Only those with clinical or biochemical signs of hyperandrogenism

 

Are PCOS and poor egg quality serve as indications for the use of Metformin in the next IVF cycle?
  • Yes
  • No

 

PCOS with habitual abortion: Is this an indication to use Metformin?
  • Yes
  • No

 

Is high insulin an indication?
  • Yes
  • No
  • I do not measure insulin level

 

Do you perform any glucose blood test before deciding on treatment with Metformin?
  • Fasting glucose test only, and treatment is initiated if pathological level is acknowledged
  • Glucose tolerance test
  • Checking glucose and insulin ratio
  • Not performing any tests related to the above

 

If you look for glucose:insulin ratio, what is abnormal?
  • Less Than 7
  • Less Than 6
  • Less Than 5
  • Less Than 4
  • Not examined

 

When do you start Metformin treatment?
  • Up to 3 months before starting the IVF cycle
  • One month before starting the IVF cycle
  • At the time of GnRH analogue initiation in a long protocol
  • At the beginning of stimulation

 

What dosage do you prescribe?
  • Between 1500 and 2000 mg per day
  • Below 1500 mg/day
  • Above 2000 mg/day

 

Do you gradually increase the dose?
  • Yes
  • No

 

Using Metformin – do you prescribe the regular or the slow release?
  • Metformin regular release
  • Metformin slow release

 

Before starting treatment, apart from glucose do you look for any specific blood test, which is related to the Metformin administration?
  • No such blood tests
  • Kidney function
  • Liver function
  • Kidney and liver function
  • WBC
  • Kidney and liver function, and WBC
  • B12 and folic acid
  • Kidney and liver function, WBC and B12, and folic acid
  • Other

 

Metformin is included in pregnancy category B, based on the FDA report, and is not expected to be harmful to an unborn fetus. Until what stage do you continue treatment?
  • Positive b-hCG
  • Recognized FHR
  • 12 weeks' gestation
  • To the end of the second trimester
  • To the delivery stage

 

Do you think that there is any association between Metformin and gonadotropin administration?
  • It reduces gonadotropin consumption during stimulation
  • It has no effect

 

Metformin in relation to pregnancy?
  • It increases the overall pregnancy rate although I have not tested it
  • The pregnancy rate in my unit is definitely increased
  • No correlation to pregnancy rate

 

Metformin in relation to miscarriage?
  • It reduces the rate of miscarriage, although I have not tested it
  • It definitely reduces the miscarriage rate in my unit
  • No correlation to miscarriage rate

 

Can you estimate the number of treated cycles (annually) with Metformin in your unit?
  • cycles Less Than 10
  • cycles 10-20
  • cycles 20-30
  • cycles 30-40
  • cycles 40-50
  • cycles 50-60
  • cycles 60-70
  • cycles 70-80
  • cycles 80-90
  • cycles 90-100
  • cycles 100-120
  • cycles 120-140
  • cycles 140-160
  • cycles 160-180
  • cycles 180-200
  • cycles 200-250
  • cycles 250-300
  • cycles 300-350
  • cycles 350-400
  • cycles >400

 

Is there a limit to the duration of treatment with Metformin if the patients do not conceive?
  • Yes, up to 6 months
  • No

 

Do you think that the data available in the literature is satisfactory?
  • The data is satisfactory
  • The data is insufficient for reaching a conclusion concerning this treatment modality