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.