TTC & Taking Clomid &/or Metformin ~ November 2006 #3

[Cuddlepie]

Hayseed, what a fabulous news! So very happy for you, I can understand that you are being caucious and don't want to get too excited too early, but this is a wonderful start (those two lines are all I wish at the moment without thinking the next step) and send out loads of to you

Debbie, I know exactly what you mean by 'dreading the bd fest' every month, too much expectation and its not that simple and fun any more. Talking about emotionally, its my first day having clomid, so far so good, maybe the side effect not kicking in yet...

BW, thinking of you, hope you had a better day today...

Flowergirl, hope AF will hold off and you will get some good news. Can I ask how many cycle you have been on 50mg before going onto100mg on clomid?

Mako, sorry to hear your news, but it might be just a tad early...chin up girl

Ktgirl, monnie, thinking of your girls and everyone else hope you all have fabulous weekend!

[butterfly_warrior]

wow!!!

It's been a long day, and it's put the hugest smile on my face to come home and find Hayseed's news! I know a lot of people may not agree with me saying this, but I feel that if there's one place that I can be honest, it's here. I'm completely over seeing girls who've been trying for 5 minutes fall pregnant, when there are others who have been going through hell for ages. Sometimes I feel like they just don't deserve it, that it's unfair (you all probably know the emotions!), but there's not a single woman in here who I wouldn't cry tears of joy for (and I am now!) if they conceived. So... Hayseed, hearing of your success is just so amazing, so refreshing and gives so much hope to me, and I'm sure the rest of us as well... Thankyou for giving us the honour of sharing your news with us.

Mako, hopefully your test was just too early. As for the metformin thing... I'd asked my friend a number of questions regarding all things TTC. I'd been thinking that it wasn't doing anything, questioning my dose (1000mg, when a lot of stuff I'd read suggested that it should be higher), and whether I should continue to take it. I'd asked such hard questions that she was forced to delve into the medical literature to find answers. Luckily, as she's still working in hospitals, she has access to a system that links her to the very latest gynecological research, and that's where her answers came from. But first, a quote from Dr John Eden, apparently the Australian PCOS guru:

Some women with insulin resistance respond to metformin therapy, which improves insulin resistance and aids weight loss. There is a lack of large-scale, properly conducted clinical trials on this drug, but the best information to date suggests that metformin (at a dose of 1.5-2g daily) restores ovulation in around 50 per cent of women with PCOS who are not ovulating.

and the other quote from my friend's email:

As you know by now, the recommended dose for ovulation stimulation is 1500 to 2550 mg per day. In non-obese women with PCOS the dose used in the studies was 850 mg twice daily. The evidence shows similar rates of ovulation with metformin or with clomid (note that these are only about 67%) but that pregnancy rates are higher with metformin. So for that reason alone I would keep taking it as it increases the chance that pregnancy will follow if you manage to get ovulation to occur. There is also a lower rate of spontaneous miscarriage with metformin. They recommend the following monitoring with regard to metformin: take for 5 weeks then have a progesterone level measured evey 7-10 days to determine if ovulation has occurred. If progesterone is greater than 5 ng then it has. If ovulation is not detected after 5-10 weeks of metformin alone then add clomid (note the RE I worked for suggested 6 months of metformin before clomid)

So that explains, sorta, the reason for the increased metformin dose. I too think it is strange that people with type II diabetes only get 1000mg, when women with PCOS get doses much higher. My friend has told me on many occasions that the use of metformin in treating PCOS is cutting edge stuff, and that to some extent it hasn't filtered through to all levels of medical professionals. My GP didn't know about it until I told him, and while my gyn did know, he'd obviously not done enough reading. I'm also told that metformin has been found to be useful in treating PCOS even when there is no insulin resistance - probably for the same reason that some IVF docs put their patients on it regardless of PCOS or not, just for the simple fact that it seems to improve egg quality.
I've always thought I was extremely lucky to have a friend who is a doctor, just for the simple fact that there's a convenient second opinion, or a quick way of finding out whether I should panic about something or not. Now that we are TTC and I've been diagnosed with PCOS I'm even more thankful for the fact that she's studying to be a gyn/obs, as she has access to the most current research regarding my treatments. I guess private specialists also have access to the research, but you never really know how up to date they are, but I know with this friend, she has a personal investment in making sure I'm treated properly by my doctors and making sure I have the most thorough and complete information possible. And in turn, I'm happy to pass on that information to other women here on BellyBelly. Now I've rambled on about metformin and my super-wonderful friend so much I've forgotten the original question! I do hope this was enough information for you, Mako.

As this is a mammoth-length post already, I shall end it here, and wish the rest of you much luck and baby dust.

BW