Effect of probiotic and metformin combination therapy on insulin resistance in polycystic ovary syndrome compared with metformin alone

Authors

  • Syeda Tashfia Jahan Department of Obstetrics and Gynaecology, Medical College for Women and Hospital, Dhaka, Bangladesh
  • A. M. O. Ibrahim Shamsi Department of Surgery, Medical College for Women and Hospital, Dhaka, Bangladesh
  • Rawnok Laila Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Itrat Aziz Department of Reproductive Endocrinology and Infertility, Bangladesh Medical University, Dhaka, Bangladesh
  • Rebeka Sultana Department of Reproductive Endocrinology and Infertility, Directorate General of Health Services (DGHS), Mohakhali, Dhaka, Bangladesh
  • Mostafa M. Al Tarique Department of Reproductive Endocrinology and Infertility, Bangladesh Medical University, Dhaka, Bangladesh
  • Jesmine Banu Department of Reproductive Endocrinology and Infertility, Bangladesh Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252716

Keywords:

Insulin resistance, Metformin, PCOS, Probiotic

Abstract

Background: Insulin resistance in PCOS can be aggravated by gut microbiota dysbiosis. Probiotics may improve microbial balance and insulin sensitivity and, in combination with metformin, improve glycemic control while reducing side effects. This study aimed to compare the effects of probiotic–metformin combination therapy versus metformin alone on insulin resistance in PCOS patients.

Methods: This randomized controlled trial at BSMMU included 60 infertile women with PCOS and insulin resistance. Participants were randomized into two groups: one received probiotics (Lactobacillus and Bifidobacterium, 4 billion CFU twice daily for 12 weeks) plus metformin and the control group received metformin alone. Fasting blood sugar and insulin were measured pre- and post-treatment to assess insulin resistance.

Results: In the experimental group (probiotics+metformin), FBS, fasting insulin and HOMA-IR decreased significantly after 12 weeks (5.1±0.6 vs 5.5±0.9 mmol/l; 10.2±3.8 vs 17.5±5.5 µIU/ml; 2.3±0.9 vs 4.3±1.5). Similar significant reductions were observed in the control group (metformin alone) for FBS (5.3±0.6 vs 5.4±0.5 mmol/l), fasting insulin (10.8±4.3 vs 17.6±7.4 µIU/ml) and HOMA-IR (2.6±1.4 vs 4.2±1.6). However, the mean changes between groups were not statistically significant.

Conclusions: Probiotic–metformin therapy improved insulin resistance, but not significantly more than metformin alone and had fewer, non-significant side effects.

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References

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Published

2025-08-28

How to Cite

Jahan, S. T., Shamsi, A. M. O. I., Laila, R., Aziz, I., Sultana, R., Al Tarique, M. M., & Banu, J. (2025). Effect of probiotic and metformin combination therapy on insulin resistance in polycystic ovary syndrome compared with metformin alone. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(9), 2898–2905. https://doi.org/10.18203/2320-1770.ijrcog20252716

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Original Research Articles