To the Editor The MOMPOD study1 revealed that for pregnant individuals with preexisting type 2 or early gestational diabetes, metformin, 1000 mg twice daily, starting before 23 weeks鈥� gestation and taken until delivery, did not reduce a composite adverse neonatal outcome but resulted in reduced numbers of large-for-gestational-age infants. However, we believe that safety issues regarding the long-term effects of metformin on male infant fertility should also be considered.