I have heard that PCO patients can have poor egg/embryo quality. Are there any consistent egg or embryo morphology findings that you see in these patients (grainy cytoplasm, fragmented polar bodies, inclusion bodies in cytoplasm, thick zonas etc.)?
This may not be a ? you can't answer but have you ever seen a patient who has poor egg/embryo quality benefit from metformin in terms of improving egg/embryo quality even if they aren't a classic case of PCOS but "may" have some symptoms of it (string of pearl appearance on ovaries, quick and good response to stims but not where hyperstimulation occurs, sl. abnormal hair growth, sl acne and overweight but w/ nl cycles and bloodwork). If the patient is not PCO, can metformin have a negative impact on egg/embryo quality or will it just not help but not hurt either?
Sorry for the delay. I've been swamped with regulatory compliance issues associated with the new FDA rules regarding screening of egg donors.
Imature eggs, poor fertilization, slow embryonic division cycles, arrested embryo development and embryo fragmentation are the usual signs of PCOS eggs and embryos.
There has been one report in the scientific literature suggesting that Metformin improves egg quality in insulin-resistant PCOS patients. These insulin-resistant patients are a special subset of PCOS patients. I am not aware of any data suggesting that Metformin improves egg quality in other types of PCOS patients or those with the associated "multicystic ovary" condition that you describe.
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