PCOS, Metformin ,1st Trimester

[E m i c h i e e]

My friend who has PCOS was put on Metformin (she is NOT diabetic) to help her conceive. She got pregnant right away and is now 6 weeks pregnant and unsure weather she should stay on Metformin.

Her doctors are undecided!! :( Does anyone know?

 

I would have guessed continue taking it not to cause any imbalances resulting into MC..

[cristeen]

My doc had me continue it until week 12, beyond that there's not thought to be any benefit.  But up to that point, it's thought to help prevent m/c in women with PCOS.  There really haven't been any studies done on it though.  It made me seriously sick for the entire first trimester though, I refused to go back on it after that. 

[Jenga]

I was on it until 14+ weeks for my last two pregnancies. Around 12-14 weeks, the second trimester, the placenta is taking over the production of hormones and tends to do a better job of providing what the baby needs if Mom can't do it because of the PCOS. That is when my OB said it was safe to go off the medication, for me at least. She had extensive experience in infertility and genetic disorders (I believe that in the US she'd have been considered to have a specialty practice). 
 

I had the option to stay on it as well because it would not hurt and can, in fact, be helpful. Women with PCOS are not just more succeptable to miscarriage, but they are also more likely to suffer a  still birth, late-term miscarriage and to develop pre-ecclampsia and gestational diabetes. If a woman is being treated for PCOS before pregnancy then her risk factors (but for gestational diabetes, however most women with PCOS are already on a pseudo-diabetic diet)  for problems during pregnancy are about average. I know women who never stop taking metformin. I am not one of them, but I am hoping to get back on metformin at 6 weeks PP. 

Metformin isn't just about sugar control, it helps to ease some of the other problems. I would also continue taking it. If her doctors are undecided then it is likely that they are not educated enough to make a decision. She should see an endocrinologist (or a reproductive endocrinologist) to see what is best for her. Perhaps a hormone level panel done by someone who may understand the benefits and risks and can discuss them with her so that an informed decision can be made.

[sunflwrmoonbeam]

I have PCOS and have been on metformin continuously since July 2008, so through a pregnancy, nursing for 2+ years, and I'm almost 22 weeks into this pregnancy and still on metformin. I DO NOT have blood sugar problems, but my body is highly sensitive to insulin issues, and the moment they drop my dose I get rather sick rather quickly. Metformin is safe for pregnancy and often better for women with PCOS. There's research that suggests that metformin can help regulat milk supply in women with PCOS (I had a mild oversupply) and help prevent gestational diabetes.

PCOS and insulin resistance are degenerative, which means the longer you go without treatment the more likely you are to develop further health problems, including Type II Diabetes. Unfortunately metformin for PCOS and in pregnancy is still rather controversial, but having read a lot of PCOS research I'm convinced it's preferable and safe.

That said, metformin is not appropriate for every woman with PCOS. If your friend has problems tolerating the side effects or didn't have insulin resistance in the first place (not everyone with PCOS does) it's probably not a great idea for her to be on it. But that's one of those things that can only be determined between her and her doctor.

I'm currently on 1500mg (500 3x a day) and will be for the foreseeable future. We won't be having any more children and I'll still be on metformin. It's not just to help fertility, but to help the underlying issues with PCOS.