Metformin plus liraglutide increases pregnancy rate in women with infertility, obesity, PCOS
CHICAGO — Women with infertility who have obesity and polycystic ovary syndrome had more increases in pregnancy rate per embryo transfer and cumulative pregnancy rate with low-dose liraglutide as an add-on to metformin compared with those treated with metformin alone, according to findings presented here.
“Our observations are not definitive, but do encourage further exploration of the impact of preconception treatment with GLP-1 receptor agonists on reproductive outcomes in different obesity-related populations,” Mojca Jensterle Sever, MD, PhD, assistant professor at the University Medical Centre Ljubljana in Slovenia, told Endocrine Today.
Sever and colleagues evaluated 28 infertile women with obesity and PCOS (mean age, 31.07 years; mean BMI, 36.7 kg/m2) assigned to metformin 1,000 mg twice per day or combined metformin 1,000 mg and low-dose liraglutide 1.2 mg (Victoza, Novo Nordisk) once a day to determine the effect of each regimen on IVF pregnancy rate and cumulative pregnancy rate over 12 weeks. Spontaneous pregnancy rate was tracked for 12 months.
Weight loss was similar between the metformin-alone group (mean, 7 kg) and the combination group (mean, 7.5 kg). Further, visceral adipose tissue and homeostasis model of assessment for insulin resistance were similarly reduced with both treatments.
Pregnancy rate per embryo transfer was higher in the combination group compared with the metformin-alone group after intervention (85.7% vs. 28.6%; P =.03). Cumulative pregnancy rate over 12 months was higher in the combination group compared with the metformin-alone group (69.2% vs. 35.7%).
No differences were observed between the two treatment groups for dosage of stimulation; number of retrieved oocytes; number of mature, fertilized and degenerated oocytes; number of embryos and blastocysts at day 5; and number of transferred embryos.
“Larger studies are needed to evaluate the safety and efficacy of preconception treatment with liraglutide in obese infertile women with PCOS,” Sever said. “Direct crosstalk between GLP-1 and [the] reproductive system needs further exploration.” – by Amber Cox
Sever MJ, et al. OR33-3. Presented at: The Endocrine Society Annual Meeting; March 17-20, 2018; Chicago.
Disclosures: The authors report no relevant financial disclosures.