Continue Metformin in 1st T for PCOS?

From Dr. Chapa’s OBGYN Clinical Pearls Dr. Chapa’s Clinical Pearls

Podcast Family, we have covered PCOS on this show many times in the past; and yet- again, there is new information! A new publication from AJOG (Gray journal) describes a new meta-analysis on preconception/continued metformin use in the first trimester. Is this helpful? How does this contrast with the 2023 international guidance update on PCOS? Listen in for details.

1. ASRM: Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023)

2. Cheshire J, Garg A, Smith P, Devall AJ, Coomarasamy A, Dhillon-Smith RK. Preconception and first-trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis. Am J Obstet Gynecol. 2025 Dec;233(6):530-547.e8. doi: 10.1016/j.ajog.2025.05.038. Epub 2025 Jun 3. PMID: 40473092.

3. Løvvik TS, Carlsen SM, Salvesen Ø, et al. Use of Metformin to Treat Pregnant Women With Polycystic Ovary Syndrome (PregMet2): A Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet. Diabetes & Endocrinology. 2019;7(4):256-266. doi:10.1016/S2213-8587(19)30002-6.

4. Teede HJ, Tay CT, Laven J, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility. 2023;120(4):767-793. doi:10.1016/j.fertnstert.2023.07.025.