Triplet pregnancy after metformin in a woman with polycystic ovary syndrome.

OBJECTIVE

To report a case of triplet pregnancy after metformin treatment only, in a woman with polycystic ovary syndrome (PCOS) and a family history of twin pregnancies.

DESIGN

Case report and literature review.

SETTING

Gynecologic endocrinology clinic, tertiary federal hospital.

PATIENT(S): A white, lean, 34-year-old woman, treated for PCOS since age 28, who had tried to conceive spontaneously for 6 months, with no evidence of ovulation.

INTERVENTION(S): Metformin, 850 mg, for 1.5 months.

MAIN OUTCOME MEASURE(S): Pregnancy (triplet).

RESULT(S): Pregnancy developed up to premature labor at 31 weeks. The patient delivered two boys and one girl, in need of neonatal intensive care for 33 to 44 days.

CONCLUSION(S): Despite the paucity of literature data, we believe that metformin, when associated with predisposing therapies or conditions, may facilitate high-order pregnancies.