Metformin improves reproductive outcomes in patients with insulin resistance

Every year, the scientific community in reproductive medicine gathers at the Annual Meeting of the Society for Reproductive Investigation (SRI). This year’s edition took place in the city of Vancouver, Canada. Researchers from around the world shared the latest advances in research focused on enhancing reproductive environments and providing hope to women and couples in need of reproductive medicine to fulfill their desire to start a family.

What is the influence of insulin resistance in recurrent miscarriages?

Among the most prominent studies by IVI researchers is “Metformin treatment decreases clinical miscarriage and improves live birth rates in infertile patients with insulin resistance.” This work demonstrates how metformin treatment reduces clinical miscarriage rates and improves live birth rates in women undergoing assisted reproduction processes with insulin resistance. It is worth noting that metformin is an oral antidiabetic drug of the biguanide type. It helps control blood glucose levels, decrease glucose absorption from food, and reduce glucose production in the liver.

“Imbalance in insulin resistance during embryo implantation and pregnancy leads to elevated levels of maternal and fetal blood glucose. This results in complications that may lead to miscarriage. The use of metformin has been described as a treatment that leads to a decrease in blood glucose levels without associated risks. In addition it improves endometrial function, positioning it as a possible treatment for women where insulin resistance is a significant factor potentially related to poorer reproductive outcomes. In this regard, we evaluated the effect of metformin on the reproductive outcomes of these women,” explains Dr. Hortensia Ferrero, researcher at the IVI Foundation and author of this study.

Recurrent miscarriages affect approximately 2-5% of reproductive-aged patients. Various pathologies have been described as possible causes of pregnancy loss:

• Chromosomal and uterine abnormalities
• Endocrine imbalances
• Autoimmune factors
• Obstetric complications
• Metabolic abnormalities

In this context, previous studies have shown that insulin resistance can significantly impact female reproductive dysfunction.

“We have observed an increase in rates of spontaneous clinical miscarriage in women with insulin resistance. This is likely due to impaired cellular glucose uptake due to insulin resistance, leading to inadequate embryonic nutrition and energy deficiency culminating in pregnancy loss. This increased clinical miscarriage rate in women with insulin resistance was significantly reduced in those treated with metformin compared to those who did not receive treatment. Additionally, we have observed an increase in the rate of live births in these patients with insulin resistance and metformin treatment compared to those who did not take it, even compared among patients without insulin resistance,” adds Dr. Ferrero.

Study of telomeres and their length to reverse ovarian aging

While aging cannot be avoided, research focuses on how to prevent it, even reverse it. This is the focus of the study titled “Telomere protection is impaired in the ovary of SAMP8 mouse model with reproductive senescence,”. This work points to telomere shortening as a sign of ovarian aging.

“Telomeres are a great marker for assessing aging. In this sense, we have seen that there is a family of proteins – shelterins – that protect and ‘care for’ these telomeres. Specifically, TRF1 is one of the most relevant. Thus, we have studied whether these protective proteins are altered in the ovaries of a prematurely aging mouse model (SAMP8), confirming indeed that prematurely aging mice have less TRF1 in their ovaries, and specifically, in their follicles. This may cause telomeres to shorten prematurely and, consequently, age prematurely,” explains Dr. Juan Antonio Garcia Velasco, scientific director of IVI, co-director of IVI Madrid, and author of this study.

It should be noted that telomeres are special DNA sequences at the ends of chromosomes, with repetitive sequences recognized as their ends, preventing the chromosome from breaking or being damaged. The potential alteration mentioned by Dr. García Velasco may result in inadequate telomere protection. That’s why understanding the mechanisms that produce it can help determine which treatments can prevent or even reverse reproductive aging.

IVI presence at the SRI Congress

In total, IVI has presented nearly twenty research presentations in this edition, addressing topics of great scientific interest. Among them are endocrine disruptors and their effect on fertility, polycystic ovaries, or stem cells, in addition to those mentioned above. At IVI, the cornerstone of success lies in its powerful research capabilities, always with the aim of providing you with the most advanced techniques and treatments.