Recent Developments

1 Metformin treatment appears to be safe during pregnancy.3 Benefits with continuing treatment may include decreased risk of spontaneous abortion, lower likelihood of gestational diabetes in those without pre-existing diabetes, and decreased insulin requirement in those who do need treatment for diabetes during pregnancy.

2 States of insulin resistance, including PCOS, are associated with a number of risk factors for cardiovascular disease. This forms the basis for the current approach to treatment, but can provoke anxiety in generally healthy young women. It is not clear whether PCOS per se is actually associated with a marked increase in cardiovascular complications, and the risk profiles of PCOS patients may not differ substantially from age- and body weight-matched controls.4

3 Other drugs that improve insulin sensitivity may have a role in management of PCOS, although experience of using these drugs around the time of pregnancy is very limited at present. Both pioglitazone5 and rosiglitazone6 have recently been shown to have beneficial effects in insulin-resistant women with PCOS.

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