Metformin during pregnancy??

Hi, was wondering if anyone had experience with actually falling pg through being helped with Metformin and how long it was before you stopped taking it?

My specialist who put me on Met didn't tell me what to do if I actually fell pg, and he is away for another week and a half. I saw my GP yesterday to get a BT to confirm pg (I think I'm 5 weeks 3 days) and when I told him I was taking Met he said 'stop it now, you mustn't take it in pg'. But I've read on the internet about small studies showing that women who continue to take Met to 12 weeks have a smaller m/c rate (as it is much higher normally for women with PCOS).

Help. Any info appreciated. Despite what my GP said, I'm still taking it until I find out properly.

Sal

I don't know if you should or shouldn't be taking Metformin per se, however I am gestational diabetic and my ob has put me on Metformin along with Insulin.

I would see your specialist asap!

Best wishes

Thanks Kelli, am going to call my doc right now!

I have been told by nick to keep taking if I get pg, and from memory Ragged blossom was told the same thing. I also have another gf who was on metformin prior to pg and is still on it now and is about 16 wks pg.

Double check, but I imagine it will be fine. Just call your dr don't worry about making an appt I do it all the time and they are fine with it :)

*hugs*
Cailin

I was seeing a reproductive endocrinologist who put me onto Metformin. She advised me at the time to stop taking it when I fell pregnant.

It's always best not to take anything unless you really have to.

She did tell me that while there didn't appear to be any problem with taking metformin during pregnancy, there was not a lot of research to fall back on. At the time there was nothing to suggest it was dangerous to use in early pregnancy.

If you were taking metformin for problems in addition to controlling insulin resistance and helping with ovulation, like diabetes or miscarriage, then it would be worth the risk.

Do whatever feels right for you until you get to see your specialist. I was closer to 7 weeks before I realised I was pregnant and stopped taking the met. My scans have not shown any problems with my baby, so looks like they can add me to the statistics for Metformin.

From what I hear, it's becoming quite a success.

Thanks for all your advice, girls.

I read a report by an RE at IVF Australia, who mentioned that a couple of observational studies have found that taking Met during early pg lowers the rate of m/c dramatically for PCOS women, who have a much higher risk. There has also been a couple of studies that show the risk of getting gestational diabetes is lower when taking Met in pg.

Now I know that these are only a few small studies, but having read that and knowing that my being pg is in a large part owing to being on Met it is going to take some serious convincing to make me stop taking it, at least before 12 weeks pg.

I think I'll post a question to Dr Lolatgis.

Thanks again!

How did you go Sal? Get any answers??

Hi Kelli,

I don't think the question was ever actually posted to Dr Nick (I'm the last to post in the Ask An Expert forum).

I got a call back from my RE (wel actually it was his receptionist, he's on holiday so she had to ask his colleague). I was told to stop taking it immediately...faced with this advice, I have stopped taking it. I am now worried sick about insulin-resistance killing the emby. Knowing that some specialists DO advise staying on it, at least to 12 weeks, while others are dead against it just confuses the heck out of me.

Geez - what a situation you have been put into.

Big hugs to you - hope that all is ok for you.

When is your specialist back?

I have the same problem being on Metformin as well as insulin - some doctors are all for it, others are dead against it.

For me it is working really well and my obstetrician is really pleased with my progress.

Let me know how you go.

Best wishes

Thanks Kelli, well I had my first u/s today (6wks) and I saw a heartbeat! So am over the moon.

My specialist is back today, but he's not really my specialist anymore (I moved away from Sydney and he is an IVF doc and well, I don't need IVF anymore!)

It might be a good thing for me to be off Met because I am absolutely paranoid about making sure I eat only low-GI food, which has so many benefits anyway.

Hi Girls,

I am new to taking medication while TTC, so may I ask a question? I have insulin resistance but havent been put on Met but I have been put on 3 cycles of Clomid starting yesterday by my specialist.

Should I be worried about my insulin resistance? I have a diet of low gi food but am not been given any other medication for insulin resistance.

Thanks for the advice girls, I am worried that if I fall pregnant, like sal says something will happen to the embryo? following from my insulin resistance.

Bel

Hi Bel, there is good evidence that the combination of Metformin and Clomid is more effective than Clomid alone, for women with PCOS and insulin resistance. So I'm surprised your specialist isn't putting you on Metformin as well. I wish I'd known about Metformin, as the first time I tried Clomid (for 4 cycles) I wasn't on Metformin.

As to falling pg, :luck: that it happens for you straight away. It is true that women with PCOS have higher rates of m/c than 'normal' women, hence me voicing fears about coming off Metformin now that I'm pregnant. I am sticking with low-GI food and crossing my fingers!

I had two cyles of Clomid and Metformin combined, but stopped taking Clomid as it made me depressed, so took a break and was taking only Metformin and voila! pregnant first month.

Can I ask you whether you have PCOS? Also, how were you diagnosed as insulin resistant? I thought it was something that was very hard to determine, but it can be assumed in women with PCOS. I chickened out of doing the GTT as I hadn't done the pre-diet requirement and found out that it could show me as 'normal' even if I did have insulin resistance. I now know that I am insulin-resistant because of the mere fact that Metformin helped me fall pg.

Hi Sal,

thanks for replying! My doc says my insulin resistance reading in Feb this year was 19 points and should be much lower, ie 12 or so. It is currently down to 16 points after 3 months of low gi food alone, so this is the reason why my GP or specialist havent recommended Met to me yet I think the specialist wants to see if Clomid works by itself?

I had an internal examination for PCOS and the result was clear, however if clomid doesnt work after 3 cycles the specialist wants me to have further testing, not sure what he wants to see maybe if my tubes are blocked?

Congrats on getting pregnant! thats excellent news! How are you going with low gi foods?

Bel

Hi Bel,

I don't mean to cast any doubts, but PCOS can't be detected by an internal exam - or did you have an ultrasound scan? Also I assume that you've had bloodtests on CD2-3 and also an CD17-21 to test for levels of FSH:LH and Prog (to indicate ovulation has occurred)?

I was diagnosed with PCOS based on quite a few blood tests as well as an ultrasound which showed the classic 'string of pearls' appearance to the ovaries.

The first time I was put on Clomid was when I saw my first OB/GYN after I suspected that something was wrong with my fertility...on the basis of one bloodtest alone he just put me on Clomid. Eventually I sought a second opinion and saw a fertility specialist (just because a doc is an OB/GYN does not mean that they have the training or experience to deal with fertility issues).

When I told the specialist what my treatment had been like, she just shook her head and told me she hears this all the time. She told me (and my third fertility doc also - I got a third opinion, this time this doc was a top-of-the-line fertility expert) that being thrown on Clomid should never happen as a first step, as other issues need to be considered first. For me, it turned out I had endo as well as PCOS, so clomid was not going to work.

I only write all this to you because I wish someone had told me about all of this early on.

I could be totally wrong, that you are seeing a fertility specialist and have had all the tests, so please ignore me if that's the case.

If you don't have PCOS then I really don't know if just having insulin-resistance increases the risk of m/c.

Sorry! You also asked me how my low-GI eating was going. I happen to like foods that are low-GI, my real issue is with chocolate/sugar cravings that I find very hard to resist.

How do you find low-GI?

Hi Sal!

I am greatful for all your advice.

I have had lots of blood tests, my hormone levels are fine. I had a ultrasound scan which showed that my ovaries are normal. So my GP and specialist recommend Clomid for 3 cycles and we will see what happens with that. If nothing happens he will up my dose of Clomid and also I will have a test to check if my tubes are ok - whats that test called? My next blood test is on day 21 to see how my hormones react to the Clomid! so fingers crossed! I am also going to get checked for my insulin resistance by my GP at this time as I am concerned about it.

Re low GI foods, at first I found this really difficult as I love bread and Pasta more than sweet! god its hard! I expecially found it hard on my trip I just came back from in Japan - no low gi bread at all there! and not much yogurt - so mainly all I ate is sushi. I guess the main thing was I walked for nearly 8hrs a day every day and ate bread for breakfast and sushi the rest of the time so I have lost 2kgs as a result so hopefully my insullin resistance is ok. I am also regularly visiting a dietican so we shall see what she says in 2 weeks time. I do sooooo miss chocolate!

Do you have MSN messanger or Yahoo messanger? love to chat to you if you do.

Bel

Hi Bel, phew I'm so relieved to hear that your doc knows what he/she is doing! So you are not a PCOSer then... your case sounds unusual, I hope clomid works a treat for you. As for when (not if!) you fall pg, your doc will keep monitoring your blood sugars very closely I'm sure, so you don't have to worry about increased m/c rates (again I was coming from the PCOS angle).

Japan sounds great - yummo all that sushi (GI about 50-55?!?). *salivating* I can't believe I didn't get a good last fix of sushi pre-pg - I would have if I had any idea I was going to fall pg!

Insulin-resistance is so cruel - everything my body craves and I love eating is extremely high-GI, I guess that's the whole crux of the problem, huh?

Yes, would love to chat, but am not set up with MSN or Yahoo...yet. I'll get myself set up and then let you know.

Hi Sal,

MSN is easier to set up and add contacts too! and easy to download too.
Heres the link for you: http://messenger.ninemsn.com.au/

look forward to chatting with you! my hotmail is bellharrison@hotmail.com

Bel