Metformin/Fertility

[Runningforme82]

Hi all,

I'm going to try to make this short and to the point but there is some back story to it all.

Anyways, our daughter is 4 years old, it took me 1+ years to get pregnant with her. I have a history of Endometriosis and irregular/heavy periods (had 2 laparoscopies). Tried some of the usual meds, clomid, metformin, etc. Nothing worked, right before going to see the infertility specialists my ob/gyn went in to clear my fallopian tubes and that month I conceived.

Fast forward a year after her birth I decided I didn't want to be on birth control anymore, so I ditched it. Hubby and I haven't been trying to prevent pregnancy nor have we really been trying hard to concieve. My cycles are all over the map, some 22 days, some 42 days. I don't feel the huge presence of Endo like I did before the pregnancy. Hubby is finally ready to make some more serious moves in regards to getting pregnant again. Talked with my OB/gyn about it and she suggests I try metformin for a few months and then HSG to clear the tubes and or laparoscopy.

My question is, what are the thoughts on metformin? She said I may have PCOS (have some of the symptoms, but not all, for example not overweight but do have irregular periods). Is metformin going to throw my body off with the progress I have made with Whole30?

I kind of just want them to go in clear the tubes and then see what happens from there for a couple of months. She gently reminded me that I'm also older too, so another case against the not ovulating regularly.

What to do......

Thoughts?

Thanks all

[Runningforme82]

Bumping for morning crowd

[lauraska]

Check out the other post in this area about PCOS. There's a lot of good info and commentary in there!

[Runningforme82]

Ok, thanks. I kind of skimmed through some of it earlier but I'll go back and see if I can find any in relation to my question.

Thanks

[Runningforme82]

After skimming the thread on PCOS again, I think what I'm really looking for (maybe I need an admin) is:

1. What is the thought process of someone going on Metformin who has not officially been diagnosed with insulin issues and/or PCOS

2. Since I'm already Whole30 adapted and that has not impacted my fertility in the last 6 months, should I consider Metformin as the next step?

3. Skip metformin all together?

I know that a lot of this has to be talked over with the doctor (Which we are in communication with this) but they are not Whole30/paleo savy so I'm trying to determine thought process of the Whole30 and fertility issues/metformin together.

Does that make any sense, lol? I guess I just don't want to screw up my body any more than it is by taking metformin.

[lauraska]

Ah, sorry if I seemed to be dismissive. Definitely didn't intend to come off that way!

I think that most Whole30 purists would recommend avoiding pharmaceuticals as much as humanly possible. I have PCOS/insulin resistance and had issues conceiving my now-almost-2-year-old son, but I didn't start eating paleo and seeking out pharmaceutical interventions until after he was born and my weight issues were spiraling out of control. I take oral bc, metformin, and victoza and have zero "Whole30 guilt" about it, but there are others who swear by the Whole30 as all they need to control their insulin levels.

My non-doctor opinion would be not to use metformin unless a) you are officially diagnosed as insulin resistant and/or you are looking to start trying to conceive again. I don't know any doc who would prescribe it without some sort of PCOS-related diagnosis and it is a fairly intense drug to be on if you don't need it.

Just my two cents. Good luck!!

[Runningforme82]

No worries thanks for your thoughts.

We are trying to conceive again (shhh that's a secret lol), so since I have irregular periods the discussion was that I may want to try a few months of metformin. We are also discussing going more aggressive and doing another scope. I haven't had one since 2007 so with my history of endo and current cramping, etc the scope is a possibility too. I'm considering switching docs within the same office so my nurse prac that I have been talking with is going to talk with the new doc.

Decisions decisions....

[amyjo]

I would ask for some more tests--have they done an ultrasound to check for ovarian cysts? Are your fasting blood sugars normal? What's your A1C? Those tests helped me get some insight on what was happening. Although I don't have any experience trying to get pregnant--my ob/gyn said I may need a progesterone (?) shot to get things started when we're ready to start trying.

[Runningforme82]

I would ask for some more tests--have they done an ultrasound to check for ovarian cysts? Are your fasting blood sugars normal? What's your A1C? Those tests helped me get some insight on what was happening. Although I don't have any experience trying to get pregnant--my ob/gyn said I may need a progesterone (?) shot to get things started when we're ready to start trying.

Food thinking, Thanks:)

When we talked on the phone we were discussing some of that as well my last ultrasound was May 2012 and it was good. I'll have to check those specific blood work ups but I believe they were normal as well.

[Runningforme82]

*good thinking

[Michaela Elmore Cogswell]

If you have PCOS it can be confirmed with an ultrasound and frankly I'd be asking the doctor to do that to be sure before you go on Metformin. The one constant with PCOS is a small group of cysts on your ovaries that form a string of pearls.

I was diagnosed with PCOS about 12 years ago. Was on Metformin for a while and lost some weight but lost my health insurance and dropped off. I tried to get back on but just got sick of dealing with the digestive issues it can cause. To me, the possible benefits, a bit faster weight loss just aren't worth how sick it makes me. If you aren't having insulin/pre-diabetes issues, I'm not sure how Metformin will help since it's meant to help you use the insulin in your bloodstream more effectively. I'd probably ask the doctor about that.

You might also want to check with some PCOS forums and see if people have had luck getting pregnant with only Metformin.

[lauraska]

Actually cysts are not always present in people with PCOS. I've had it for the greater part of my life and never had an actual cyst. It is true, however, that metformin will not really make a difference for anyone who doesn't have insulin resistance issue. And not all PCOSers have insulin resistance.

If you do have IR, however, Metformin might actually bring your periods back. It did for me. Both my general physician and my gynecologist have made me PROMISE that I'm back on birth control because Metformin worked so quickly and effectively to help me regain my fertility. (They both know I'm not looking to have another child any time soon.)

[Gskupaka]

Ahh I found someone like me! I don't have any children and I haven't tried, but I know it won't be easy. I hope to get pregnant this year, but I'm afraid it won't be that easy. I have been told I have PCOS but there has never been evidence of cysts. Additionally, I have been on Metformin for 3 years and the doctor originally had me on 1000mg a day, but I cut it to 500mg and my insulin levels are fine. I want to get off the med, but I am afraid of just going cold turkey. Since my first period at 12, I have never had a normal cycle 35 days or 60 days or 100 days, etc. Plus, I will bleed for months. I am doing this Whole 30 to try to heal my body, but I don't know what to do about my meds either.

[Renee Lee]

One of the benefits of metformin (and one of the reasons it's effective for so many different diseases) is that it really helps with inflammation.

PCOS, diabetes, etc are, at their roots, diseases that are exacerbated (and perhaps caused) by inflammation. Resolving the inflammation through meds is a good first step...but if you don't address the cause of it, you're just putting a bandaid onto something that will never fully heal.

Especially where hormones are concerned, I can't tell you that W30 is going to fix everything and you'll pregnant next week...BUT it IS a really good first step. The longer you stick to an anti-inflammatory diet (like the W30), the better equipped you're going to be to resolve what you've got going on.

I don't know a ton about metformin besides what I posted above, but if I were in your shoes, I would talk to my doc about what a metformin intervention would/should do, and how long I'd be on it, what we could do to get me off of it, etc.

Checking in with a functional medicine doc, maybe through the paleo physicians network, is another step that I would take.

Good luck!!