Statistics on PCOS and miscarriage ?

[*Rach*]

Hi,
I was just wondering what the statistics are on PCOS and miscarriage. Has anyone concieved and had managed to have a full term pregnancy first time around?

Thanks

Rach

[Kirsty77]

Hi Rach

I have PCOS and needed clomid to conceive and my first pregnancy was uneventful and I had no problems at all. I'm not sure what the statistics are but I'm guessing they are quite low.My gyno did tell me but I can't remember and I just wasn't that concerned about it to be honest.

[Cherie]

Rach, I've read figures like 40-45% miscarriage rate a few times, and supposedly in the 'normal' population, the miscarriage rate is around 25%. Apparently a lot are under-reported, because it may be mistaken for AF arriving.

Whilst that seems like a scary figure, I suppose it means that 55-60% don't miscarry. This is something I worry about myself, since I'm TTC my first and have PCOS.

[kyliealysha]

I found this article which was interesting. Am definitely planning on staying on metformin as long as my endocrinologist will let me! According to this, the miscarriage rate in untreated women with PCOS is 64% :shock:

ARLINGTON, VA. -- Metformin, a drug that allows women with polycystic ovary syndrome to ovulate normally and conceive, should be continued throughout their pregnancies because it also prevents miscarriage, Dr. Charles J. Glueck reported at the Clinical Research 2001 meeting.

Interim results of the ongoing study of 156 women with polycystic ovary syndrome (PCOS) who have received metformin throughout pregnancy showed 54 normal live births, 19 first-trimester miscarriages, 2 tubal pregnancies, and 81 ongoing pregnancies that appear normal on sonography at 13 weeks or more of gestation.

"So 87% have had a favorable outcome to date, and the rate of first-trimester miscarriage has been cut to 12%--which is about the national average in 'normal' women who have no endocrine disorders," commented Dr. Glueck of the cholesterol center at Jewish Hospital, in Cincinnati.

In fact, in a series of 183 pregnancies at his institution in which women with PCOS were not treated with metformin, the first-trimester miscarriage rate was a striking 64%, and the live birth rate was only 35%, he said at the meeting, sponsored by the American Federation for Medical Research.

Dr. Glueck speculated that the high miscarriage rate in PCOS is probably due to high levels of plasminogen activator inhibitor, which are markedly reduced by the metformin therapy. In untreated patients, these high levels can lead to thrombosis in the intervillus arteries and placental insufficiency or placental thrombus formation.

Dr. Glueck has also done "long-distance follow-up" on a separate group of 135 pregnancies in which the women were treated with metformin at his hospital to conceive then returned to their distant homes and their regular physicians for pregnancy management.

Physicians for 29 of these women stopped the metformin as soon as pregnancy was confirmed, and 6 of them (21%) had first-trimester miscarriages. In contrast, of the 106 women whose physicians continued metformin therapy throughout pregnancy only 13 (12%) have had a first-trimester miscarriage.

The drug has not produced any adverse effects on either the mother or fetus. "The overwhelming majority of the live births have occurred at 37 weeks or later," and the infants' weight and height distribution matches the national average almost exactly he noted.

Once metformin, an insulin-sensitizing agent, was found to induce normal menses and facilitate pregnancy in women with PCOS, attention turned to the outcome of those pregnancies.

In the question-and-answer session following his presentation, Dr. Glueck noted that metformin also may be preventing the development of gestational diabetes in these patients.

The average weight in the cohort of 156 women with PCOS was 226 pounds at conception, and most of the women were extremely insulin resistant. Yet the rate of gestational diabetes was only 4%. "Compare that with a rate of 58% seen in untreated women with PCOS, and it's clear that metformin drastically reduces gestational diabetes," he said.

The average weight gain in treated women was 11 pounds, and "many ended pregnancy thinner than when they started. In this patient population, that is a good thing," Dr. Glueck said.

When asked whether clinicians will soon be using metformin in women who develop gestational diabetes, Dr. Glueck answered that he considers it the drug of choice for such patients.

COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group

[snowflake]

I was impressed with the line "many ended up thinner than when they started"

[Cherie]

Thanks for that info kyliealysha. Sounds like metformin has some real benefits, not just for miscarriage, but for the rates of gestational diabetes as well.

I love the bit about ending up thinner .... seems like I've spent the last few years getting fatter.

[Visitor9]

I miscarried the first and second in the second trimester but for other reasons than PCOS.
Bec

[Liz]

This is my first pg and bubby has stuck around I stayed on metformin for the first 12 weeks. I had some spotting around weeks 7/8, so don't know if the metformin helped that not turn into a m/c or not. I think it was just a bit of spotting due to things stretching etc.

Good luck with TTC

[*Rach*]

hello,
Thanks everyone for their reply, it makes me feel a lot better. I am 6 weeks pregnant and am making myself sick with worry over something going wrong. I am not on Metaformin the Dr hasn't ever mentioned it, I have my first u/s on the 30/11, i will bring it up then.. My biggest worry is something happening and not knowing until the ultrasound...
Thanks for your help..
Rach...

[Cherie]

Rach - I'm sure it's much much easier said than done hunny, but try to relax and enjoy your pregnancy. It's a wonderful amazing time for you ... I'm sure everything will be perfect for your scan on 30/11

[EJE]

I think I have been quoted every statistic there is with relation to PCOS and MC. Anyway I started on Metformin in May, was pregnant by July. I was told to stop the Metformin as not enough tests had been done on babies who were born whilst their mothers took Metformin. Unfortunately I had a MC in Sept. I am now back on Metformin, and this time have been told if I become preganant again to stay on the Metformin for at least the first 12 weeks, to try to reduce the chance of another MC. Anyway all I can say is it is all very confusing, and I am not sure that even the doctors know all of the answers or statistsics!

[Mel09]

I was on on Met for a couple of months berfore pg, and stopped at about 4-5 weeks. My Dr said that there is many more studies to show that takeing Met makes no difference than the ones that say its better to take it.

Fingers crossed this bubba sticks! I couldn't handle another MC...

Dr did say that it was up to me, but she would rather pg women not to be taking anything.

As Met hasn't been used with pg for verylong, they are not aware of any long term effects... like the possibility of baby's being more prone to diabetes etc...

All a matter of time, but a very very interesting subject nun the less!

[mac29]

I was on metformin for 5 months when i fell pregnant even though the docs said i never would. my PCOS went untreated and undiagnosed for 13yrs and was very advanced by that stage. Metformin is deffinately a miricle drug. The docs have classed me as high risk pregnancy due to the severity of the PCOS and the effects it has had on my body over the years but bubs is extremely healthy and kicking me nicely as i type lol (gotta love that feeling) so all should hopefully go well. unfortunately thanks to metformin in 5 months i lost 32kg but now i have put a fair bit of it back on because the docs took me off it as soon as we found out about our lil peanut.
To all those out there TTC with PCOS GOOD LUCK!! i wish you all the best and i hope you recieve your gorgeous lil bundle of joy very soon.
Have a great day
Mel

[Rouge]

Well for me I can definitely say Metformin has had soemthing to do with this baby staying put! I conceived twice and miscarried both times and wasn't taking my metformin properly, one cycle not at all. I also started taking astrix (low dose asprin) which I think also helped this bubba!

My gyno believed that Metformin does definitely help improve the chances of carrying to term. I was told by both my gyno & my current OB to continue taking Metformin till 12 weeks so I did.

Goodluck!

*hugs*
Cailin

[*Belle*]

Hi Girls

Your posts are wonderful and thank you so much KylieAshlyea for posting the article I showed DH and he was very impressed. I am so happy my Specialist has given me Metformin to take as a result of my m/c in July, I am hoping it works soon and I get BFP.

Bel
xxx