Clomid, Metformin or both? (PCOS)

[tantylynn]

I was diagnosed with PCOS a few weeks ago and I've been doing research in preparation for my visit to the fertility specialist in May. It seems that the first stage of treatment is generally either Clomid or Metformin, or a combination of the two.

Anyone have an opinion as to which works best?

I keep thinking that I should just trust whatever the doctor recommends, but after all of the horror stories I've read of doctors who didn't have a clue I wanted to go into the appointment with some research and ideas of my own.

Any advice/help/experiences would be greatly appreciated!

Thanks!

[Rainy229]

Tantylynn- The research I've done, I chose to start with metformin - a lot of women start ovulating once their insulin (and possibly blood sugar) levels normalize.  There is some evidence that metformin also protects against 1st trimester miscarriages in women with PCOS as well, but nothing conclusive.  

I can speak only for my experience - once I started metformin and decreased my work stress, I started ovulating.

Best of luck!

Rainy

[tantylynn]

Hi Rainy, thanks for your response! I'm so glad to hear that the metformin and stress relief got you Oing again!

I've also read such good things about metformin, I am really hoping that they will include it in my treatment from the get-go. Especially since so many people (even the nurse I met with at the fertility clinic) have told me that PCOSers don't generally respond to Clomid on its own. I felt like saying "really? then why do you want me to do exactly that??" ugh.

I don't know if I am IR, though - which I think may pose a problem. I'm also normal weight...I hope that doesn't effect my OB's willingness to let me try metformin.

[Rainy229]

You can have a 3-hour GTT (glucose-tolerance-test) drawn - specifying insulin levels  - to determine if you're IR.  I'm overweight, but that's d/t a drastic change in activity level without a change in diet (I had a major injury that impacts what activities I can safely participate in), and was showing minor IR with "great" blood sugars.  

After the 3-hour GTT w/insulin, you can see if you're IR or not - if not, there may be no benefit to met... but if you ARE IR, then your MD should put you on met - even if not for the purpose of TTC - untreated IR can lead to diabetes and other serious negative health outcomes.  

I say this to everyone, because I have worked in healthcare and am HORRIFIED by what I have seen: YOU HAVE TO BE AN ADVOCATE FOR YOUR OWN HEALTHCARE!!!  If your doctor won't do the blood test, go to someone else who will - you are a CONSUMER of healthcare - tell the medical community what you want by spending your healthcare $$ where you are getting what you want!  You wouldn't order the world's best sushi and be okay when the waiter says, "No, you can't have sushi, I'll bring you tilapia."  You'd go elsewhere, right?!  Same thing with medicine!

Okay... off my soapbox and to bed with my tired brain!

--Rainy