Case series of rosiglitazone used during the first trimester of pregnancy.

Prior to 2007, use of the insulin sensitizer metformin was widely advocated in patients with polycystic ovarian syndrome (PCOS) both to promote ovulation and decrease the incidence of PCOS-associated obstetrical complications. However, the gastrointestinal disturbances associated with metformin led many to discontinue its use. Rosiglitazone is an insulin sensitizer that, because of minimal associated gastrointestinal disturbance, was used as an alternative to metformin in PCOS patients. From 2003 to 2005, 8 women with PCOS unable to tolerate metformin used rosiglitazone for ovulation induction and during their first 12 weeks of gestation. All delivered healthy babies at term, without obstetric complications or congenital anomalies. However, given recent evidence that disputes the reproductive benefits of insulin sensitization for PCOS and that raises safety concerns of rosiglitazone, we are no longer using it for PCOS treatment.