This paper evaluates the effects of berberine compared to metformin in women with polycystic ovary syndrome who undergo IVF treatment.

Polycystic ovary syndrome causes infertility, an excess of androgen (male sex hormone) and anovulation (eggs not released from the ovaries). It is associated with excess levels of insulin (hormone controlling blood sugar levels) and insulin resistance which affects blood sugar levels. Women with polycystic ovary syndrome who are insulin resistant and undergo in-vitro fertilization (IVF; fertilization of the egg outside the body) have a lower conception rate.

It is believed that suppressing insulin levels with an insulin sensitizer (drug that controls blood sugar levels) can improve ovulation (release of eggs from the ovaries) and pregnancy rates. Berberine is an effective insulin sensitizer with effects similar to metformin (Fortamet, Glucophage, Glumetza, Riomet). Hence berberine's effectiveness was compared with metformin. 

Infertile women with polycystic ovarian syndrome who were referred for IVF treatment were recruited. Patients with liver or kidney disease were excluded. Patients had been unsuccessful in conceiving for at least 2 years. Patients' body mass index (BMI) and waist to hip ratio was calculated at the start of study and after 3 months of treatment. Their hormone and insulin levels were also measured.

Patients were randomly assigned to receive berberine, metformin or placebo (a substance that has no therapeutic effect) for 3 months. After that, IVF treatment cycle was started. The patients' egg cells were retrieved and fertilized outside the body. There were 37 patients in the berberine group, 38 in the metformin group and 34 in the placebo group. These patients successfully experienced embryo transfer.

Results showed that BMI, waist circumference and waist/hip ratio decreased in all 3 groups. There were significant decreases in total testosterone (male hormone) and androgen levels in berberine and metformin groups.

Pregnancy rates were higher in the berberine and metformin groups. Birth rate was higher for patients taking berberine. The percentage of clinical pregnancies (activity of fetal heart) was 59.5% (berberine), 47.4% (metformin) and 29.4% (placebo). The percentage of patients who gave birth was 48.6% (berberine), 36.8% (metformin) and 20.6% (placebo). There was also reduced incidence of severe ovarian hyperstimulation syndrome (swollen and painful ovaries) in both the berberine (5.4%) and metformin (5.3%) groups compared to placebo (17.6%). 

The authors concluded that both berberine and metformin are similarly effective for treating excess levels of insulin and androgen. Both improve pregnancy rates for women with polycystic ovary syndrome undergoing IVF. 

If considering IVF treatment while suffering from polycystic ovary syndrome, discuss with your doctor the possibility of taking berberine prior to the procedure.