Anyone have PCOS and is or was taking Metformin?

[MarineWife]

I have had several first trimester miscarriages in between my successful pregnancies. I was diagnosed with PCOS in 2003 and put on metformin as a precaution. For 3 of my 4 successful pregnancies (including this one so far, I've made it to 12w) I've had to take a combination of metformin, progesterone and low dose aspirin.

I saw a MFM doc today who told me to stop the metformin in a week but then wants me to do a 1 hour GTT 3 days later. He says I'm at a higher risk for GD because of the PCOS, taking metformin and because I was diagnosed with borderline GD when I was pg with my 2nd child. I've had my A1C checked regularly since I was diagnosed with PCOS and it's always been really good. I've never had any other signs of diabetes or prediabetes or insulin resistance. I don't take the metformin for that. I take solely as a precaution because I have PCOS and have had RPL. When I was diagnosed with GD before it was mainly because of the PCOS and taking metformin for the 1st trimester and that my 1st 3 hour glucose level was high. The 2nd was right at the high limit of normal and the 3rd was well within normal. I was told that, technically, I did not have GD but the doc wanted to treat me as if I did because of the other stuff. That has now followed me everywhere. When I was pg with my 3rd child, I failed the 1 hour GTT and refused to take the 3 hour. My HCP and I compromised that I would eat a normal breakfast and then get blood draws every hour for 3 hours. My glucose levels then were perfect.

So, I'm wondering if a 1 hour GTT is really necessary, especially this early in the game. I really don't want to take this test. It always makes me feel so sick. I have always failed it in the past but have never had it this early. IDK what I want to do.

Anyone know about or have experience with PCOS without insulin resistance, prediabetes or diabetes putting you at higher risk for GD?

[Stayseeliz]

I was on metformin with my youngest and weaned off at 16 weeks. Had only one GTT with that pregnancy and passed. I'm almost 28w now and still on 850mg metformin. One GTT this time and passed with a 102 last Friday. I did eat eggs and a granny smith apple before my test last week and did fine.

If you have a history of miscarriage I wouldn't go off metformin yet. Metformin helps with blood sugar. My dr even mentioned that last week. I take metformin for my PCOS. Not sure if they'll wean me off of it at all this time. I know a friend of mine never weaned off hers.

[MarineWife]

I took metformin when I was pg with ds2 and ds3. I always went off it at the end of the 1st trimester without incident. Waiting another week is actually longer than I've ever been on it in the past. I really want to get off it because I have a hard time swallowing pills. Plus, I feel nauseous anyway so trying to swallow a bunch of pills is even harder. All my miscarriages occurred by 8w. I've never had a problem with my blood sugar levels, either.

I've never been told I needed to do a GTT earlier than the norm so I think that's one reason why this is bugging me. I hate the test at any time. I also hate the idea of possibly being labeled as having GD when it maybe isn't really an issue.

There are so many differing opinions on this. The MFM doc I saw yesterday told me that metformin is not the pill of choice for managing blood sugars during pregnancy. He told me what was but I can't remember the name now. I've had other doctors tell me that I shouldn't be on it at all. I've read that some docs have their patients stop taking it at the end of the 1st trimester while some have them stay on it their entire pregnancy. It's all so confusing.

The problem is that there isn't any definitive scientific data that shows that one way or another works best. As a matter of fact, I've even been told by a doctor that the scientific data actually refutes the idea that metformin reduces the risk of miscarriage at all. The studies available show that taking metformin does not significantly lower the incidence of miscarriage in women with PCOS.

[nintendork]

I was diagnosed with PCOS many years ago and later with insulin resistance and have been taking metformin for many years (prior to TTC and pregnancy).  My doctors actually wanted me to increase my metformin dosage during TTC and pregnancy.  I haven't had any blood sugar issues at all this pregnancy (passed the GD test with flying colors).  I was under the impression that you only needed the metformin to treat the IR that sometimes accompanies PCOS, otherwise you don't need it.

[MarineWife]

There are a lot of conflicting opinions on if or when to use metformin with PCOS. It makes sense to take it if you have IR anyway, I guess. I don't really know about that. It prescribed to me when I was first diagnosed back in 2003 as a precaution. My personal experience has been that when I take 1500 mg metformin and low dose aspirin, I have successful pregnancies. Whenever I have gotten pregnant without taking both of those, I have miscarried. Do I or any of my HCPs know for sure that it's one or both of those meds that make me have a successful pregnancy? No, but no one can say it's not, either. So, I take metformin for the first trimester just to be safe.

What I'm wondering is if taking metformin early in pregnancy and then stopping it puts me at higher risk of developing gestational diabetes (assuming you believe that there is such a thing in the first place) earlier and, therefore, I need to be tested as soon as I go off the meds.