Any medication that promises to make you pregnant (or at least markedly increase your chances) and make you lose weight seems too good to be true. Wait, so I can eat ice cream and French fries while losing weight and getting pregnant? Count me in! But like most things that sound too good to be true, so is the hype surrounding metformin.

Metformin is a medication that is traditionally used to treat diabetes. It lowers sugar and insulin levels: hence, why it is used for diabetes. For women with PCOS, in whom insulin levels are high, metformin can not only improve the abnormal glucose/insulin situation but also improve ovulation rates. When metformin was released as an ovulatory agent, it became all the rage for women with ovulatory dysfunction. It was handed out like candy to anyone who had even the slightest ovulatory issues. However, while it was in the medicine cabinets of thousands of women, it didn’t stand up to all the hype. It didn’t turn ovaries of stone into sand—many ovaries still stood their ground.

Turns out, metformin is not a magic potion. A large randomized control trial (randomized control trials are the gold standards of medical research) did not show that metformin was even in the same ballpark as Clomid. Women who took Clomid ovulated and got pregnant at a much higher rate (about three-fold higher) than women who took metformin. Additionally, the metformin-Clomid combination was no better than Clomid alone. The only group of women in whom metformin was semi-magical was overweight/obese women with metabolic disturbances (elevated sugar and triglyceride levels, abnormal liver function, and high cholesterol). In these women, metformin combined with diet and exercise could be quite helpful in kicking the ovaries into gear. Additionally, this dynamic duo can significantly improve your overall health, wellness, and longevity.

With the pluses come the minuses. Metformin can make your stomach feel a little funky; be sure to talk to your doctor if you experience GI side effects (bloating, diarrhea, etc.). It is also important to have your kidney and liver functions measured while taking metformin, as it can do some not-fun things to your kidneys and your liver. While there are certainly occasions and cases where metformin is the magic ingredient, it’s not the “butter” in the ovulation concoction. It may help with the flavor, but it isn’t the force behind what gets the ovaries going.
Don’t fool yourself into thinking that metformin is magic. You still need to eat right, exercise, and maybe even take some Clomid. We will find some cocktail that makes your ovaries shake!