September 16, 2002 07:34:38 AM PST, Reuters

Woman who are resistant to the hormone insulin may face an increased risk of miscarriage, according to the results of a new study.

The findings, say the researchers, offer a possible strategy for preventing miscarriage in women with insulin resistance who have suffered repeated pregnancy loss.

Insulin is the hormone responsible for depositing glucose (sugar) from the blood into body cells for use as fuel. People who are overweight can grow resistant to the hormone, which in turn increases the risk of developing type 2 diabetes.

Women with polycystic ovary syndrome, a condition marked by insulin resistance and excessive amounts of "male hormones" like testosterone, face fertility problems and recurrent miscarriages. But one study found that treating these women with a drug that lowered blood insulin levels helped reduce their miscarriage risk, Dr. LaTasha B. Craig and colleagues from the University of Tennessee in Memphis note. (* report of this study is posted below)

Craig and her team decided to investigate whether women without polycystic ovary syndrome who had suffered miscarriages repeatedly might also have insulin resistance. They report their findings in the September issue of Fertility and Sterility.

The researchers evaluated 74 women aged 22 to 46 who had suffered at least two previous miscarriages, comparing them with 74 similarly aged women who had at least one child. The control women and the study group were also similar in terms of their body mass index (BMI), a measure of weight in relation to height used to gauge obesity.

Among the women prone to miscarriages, 20 (27%) were insulin-resistant, compared with 7 (9.5%) of the women with children, the investigators found.

"Mechanisms to associate insulin resistance with recurrent pregnancy loss are unknown," the authors write. "One hypothesis is that insulin resistance causes an uncontrolled diabetic-like state in the fetal environment resulting in increased first trimester loss (of pregnancy)."

The findings suggest, according to Craig and colleagues, that drugs that decrease insulin levels in the blood may help insulin-resistant women who are prone to miscarriages have successful pregnancies.

SOURCE: Fertility and Sterility 2002;78:487-490.

http://health.yahoo.com/search/heal...=s&p=id%3A28385

Diabetes Drug Cuts Miscarriage Risk

February 28, 2002 03:55:46 PM PST, HealthScout News

By Adam Marcus
HealthScoutNews Reporter

THURSDAY, Feb. 28 (HealthScoutNews) -- One of the most popular pills to treat diabetes appears to dramatically reduce the risk of miscarriage in women with ovarian cysts linked to pregnancy problems.

Earlier research has shown that the drug, metformin, can improve the odds of conception in women with polycystic ovary syndrome (PCOS). However, the latest work, which appears in the current issue of the Journal of Clinical Endocrinology and Metabolism, shows it may also increase their chances of a successful pregnancy once they've conceived.

Polycystic ovary syndrome is a leading cause of female infertility and miscarriage, which occurs in between 30 percent to 50 percent of pregnancies in women with the condition. The disorder affects 5 percent to 10 percent of American women of reproductive age. It is characterized by cysts in the ovaries that are egg follicles in a state of arrested development, unable to ovulate.

One feature of PCOS is high blood levels of insulin, the hormone that lets cells turn sugar in the blood into energy. Metformin -- sold under the brand name Glucophage -- makes cells more sensitive to the hormone, but experts say why it might prevent miscarriages is a mystery.

Some evidence suggests that in addition to improving the body's response to insulin, the drug may also increase blood flow to the uterus and make the womb more hospitable to the developing fetus.

Many women with PCOS also have elevated male sex hormones, or androgens, potentially disturbing fertility. Too much insulin is believed to promote androgen production, so metformin may also ease that problem.

In addition to reproductive complications, the cysts are linked to a wide range of health problems, including obesity, high blood pressure, hardened arteries, and, because of the added male hormones, abnormally heavy body and facial hair.

Since women with PCOS don't ovulate regularly, they often seek fertility treatment. Scientists have been using metformin, which was approved for the treatment of diabetes in 1994, to give ovulation drugs a boost.

The new study, by researchers in the United States and Venezuela, was a retrospective look at 96 women with PCOS, 65 of whom had taken metformin to help them ovulate. There were 68 pregnancies in the group that received the drug. Six of them -- roughly 9 percent -- ended in miscarriage during the first three months of pregnancy.

However, 13 of the 31 pregnancies -- 42 percent -- among the women who didn't get the diabetes drug aborted prematurely. In other words, women who took metformin were 4.5 times less likely to lose their fetuses in the first trimester.

When the researchers studied the drug among a smaller group of women with a history of miscarriage, they found it to be even more protective, reducing the risk more than fivefold.

One baby whose mother took metformin developed a birth defect, called achondrodysplasia, a form of dwarfism. However, whether that was the result of the drug isn't clear.

Louis DePaolo, a program officer at the National Institute of Child Health and Human Development, which funded the research, said that for a relatively small study the magnitude of risk reduction was impressive.

"If it was 10 percent versus 20 percent, I'd say forget it. But my guess is that even if it turns out to be a two- or threefold change, that's going to be highly significant in terms of treatment," DePaolo says.

DePaolo cautions that since the study was retrospective, it must be considered preliminary. The institute is now weighing whether to fund a trial with metformin to look specifically at whether it cuts the risk of miscarriage in women with ovary problems.

Dr. Mark Perloe, medical director of Georgia Reproductive Specialists, a fertility clinic in Atlanta, says the findings "make sense from a scientific standpoint," and the results are "certainly the case that we have seen here." However, he also warned that it's tricky to draw conclusions from retrospective studies.

What's more, Perloe says, there's disagreement in the medical community about which women should be treated for ovary cysts. Some clinics are more liberal in their view of when to treat the syndrome, while others are more conservative.

http://health.yahoo.com/search/heal...=s&p=id%3A15530

You know? I already see an endocrinologist for my thyroid disease and the last appointment we talked about my IR and she said that "High insulin is toxic to the ovaries..we don't know why but it is" Thanks for posting this Doreen...this has assured me that my doctor is on top of current clinical studies. I already liked her (she's been my godsend) but this just adds a bit more cement to the mix....

I also found this very informative and helpful!
Poofie!