The role of metformin in the management of endometriosis: A systematic review and meta-analysis

Abstract

Purpose: To analyze the activity of metformin in endometriosis, with a view to alleviating disease progression. Methods: A search was conducted using electronic databases such as CNKI, VIP, CBM, WANFANG, Embase, PubMed, Cochrane, and Web of Science from  January 1980 to January 2022 for randomized trials involving any intrapartum fetal surveillance method. A network meta-analysis was performed within  a frequentist framework, and it was assessed for quality and network inconsistency of the trials. A ninety-five percent confidence interval (CI) was used to  report the relationship between metformin levels and patients with endometriosis. Results: Eight eligible studies which included 688 patients were evaluated in this meta-analysis. The primary indicators were treatment efficiency and  CA-125 level. Metformin significantly increased treatment efficiency (SMD = 3.29, 95 % CI 2.01, 5.40, p < 0.00001). As expected, metformin also reduced  the CA-125 level in endometriosis patients as a result (Odds Ratio, OR = -1.20, 95 % CI: -1.40 - 1.00, p < 0.00001). Conclusion: Metformin alleviates pains caused by endometriosis. However, some studies had scanty information about alleviating clinical symptoms  other than basic medical research. More randomized controlled trials are needed to confirm treatment efficacy.