The Hidden Impact of Metformin on Fertility and Egg Quality

Dr Agnes Ryu

Metformin, a medication primarily known for managing insulin resistance and as a standard treatment for polycystic ovary syndrome (PCOS), has long been lauded in medical circles. However, emerging research reveals metformin’s potential drawbacks, particularly regarding fertility, egg quality, and mitochondrial health.

Metformin remains the first-line drug for regulating blood sugar and improving insulin sensitivity in conditions like Diabetes, insulin resistance and PCOS. Yet, its widespread use warrants a deeper look at its broader health impacts, especially on delicate reproductive functions.

Initially hailed in longevity circles for its potential to extend lifespan akin to caloric restriction, metformin has faced a recent decline in off-label use. This shift likely stems from studies unveiling its complex cellular interactions, including mitochondrial toxicity.

As the cell’s powerhouses, mitochondria play pivotal roles in energy production. By interfering with mitochondria’s electron transport chain, metformin can hinder their efficiency. With mitochondria being vital for numerous bodily processes, these disruptions raise concerns about metformin’s long-term effects.

Metformin for PCOS and Insulin Resistance

For years, metformin has been the go-to treatment for conditions like PCOS and insulin resistance. Its effectiveness in regulating blood sugar levels and improving insulin sensitivity has made it a mainstay in therapeutic protocols. However, the broad use of metformin, especially among those who are pregnant and who want to get pregnant, calls for a deeper understanding of its broader impacts on health, particularly regarding mitochondrial function and reproductive health.

Metformin and Mitochondrial Toxicity

Mitochondria, crucial for energy production, are significantly impacted by metformin. The drug’s interference with the electron transport chain, specifically at Complex I, can lead to reduced mitochondrial efficiency and energy output. This disruption poses questions about the long-term cellular and systemic effects of metformin, especially considering that optimal mitochondrial function is vital for numerous bodily processes, including those related to fertility and egg quality.

Impact on Fertility and Egg Quality

For aspiring parents, optimal mitochondrial activity ties directly into fertility and egg quality. As oocytes contain high concentrations of mitochondria, their integrity influences embryo development. Metformin’s impacts on mitochondrial function may therefore impede reproductive potential, especially among fertility patients with PCOS or insulin resistance.

While metformin remains a cornerstone in the treatment of PCOS and insulin resistance, its broader impacts, particularly regarding mitochondrial function and fertility, warrant careful consideration. As healthcare professionals, it is imperative to stay informed about the latest research and developments in this area to provide the best possible care to our patients. At Dr. Ryu’s Natural Fertility Clinic, we are committed to exploring all facets of treatment options to ensure our patients are receiving care that not only addresses their immediate health concerns but also supports their long-term well-being and reproductive goals.


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Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

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