FINALLY a Diagnosis
Question:
re: metformin Have you had a glucose tolerance test? If you are at need for Metformin for its real use (hyperglycemia – prediabetes, etc) Then your RE is doing you a disservice not checking. My RE did prescribe metformin, although it took 3 months to see effects. I eventually did get a glucose tolerance test and have high numbers, so now, I have to take it whether he would want me to or not. Kaitlyn My RE has told me he has seen a marked improvement with PCO women undergoing
IVF when they did take Metformin that cycle versus when they didn’t. He said egg quality improved greatly after taking Metformin. – Hide quoted text — Show quoted text -My RE disagrees (oh well…). Then again, your RE has tried it, and mine hasn’t. I am an IVF patient, and asked if metformin would help. He said that metformin has not been "proven", to his satisfaction, to have any beneficial effect in *IVF*, and he won’t allow me to use it.
Response:
I really do think we agree. I was not arguing with you, at all….I was merely augmenting your post by stating that clomid (alone) can increase the miscarriage rate even further….is probably a matter of semantics.
I did misunderstand you, but I understand your point now and you’re right – I think we agree!!! Speaking of semantics, I think we are misunderstanding each other when referring to "egg quality". To me, "egg quality" is the inherent quality of eggs *before* stimulation. In this sense, I don’t think anything can improve this quality. However, once the follicle becomes stimulated, the egg quality can be harmed by things such as excess LH (or androgens) …therefore decreasing the *ultimate* quality, upon ovulation. Semantics, again…… (forgive me if none of this makes sense….)
Makes perfect sense. When I think of "egg quality" I always think of quality of egg upon ovulation. I’d never thought of it the way you do – before stimulation. I guess that’s why I had some problem/question about your previous response. <<My RE has told me he has seen a marked improvement with PCO women undergoing IVF when they did take Metformin that cycle versus when they didn’t. He said egg quality improved greatly after taking Metformin. My RE disagrees (oh well…). Then again, your RE has tried it, and mine hasn’t. I am an IVF patient, and asked if metformin would help. He said that metformin has not been "proven", to his satisfaction, to have any beneficial effect in *IVF*, and he won’t allow me to use it.
When I initially asked to be put on Metformin maybe a year ago, my RE refused too. It wasn’t until last summer that he decided to give it a try (don’t know what changed his mind) and saw the great results. In fact, I’m the first of his patients NOT to ovulate regularly on Metformin alone. Go figure! Maybe it’s just a matter of time before all drs will at least consider trying it. Just as a side note Kay, I always read your replies to everyone’s posts whether or not it’s a topic I would normally be interested in. They are always so well written and informative. I always appreciate your dialogue. Take care! Nicole
Response:
<<It was my understanding that being on the Metformin helped lower the androgen levels so that the egg had a healthier environment in which to grow. Is this not your understanding as well? Absolutely!! Excessive androgens elevate LH, and I believe it’s the *LH* that directly causes egg deterioration, not the androgens. (I have never heard of androgens "directly" affecting egg quality, but I suppose it’s possible….will do some checking) In my previous post, I said that "clomid (alone) can diminish egg quality, by causing them to mature too early." "alone" = without metformin or androgen-lowering meds. I really do think we agree. I was not arguing with you, at all….I was merely augmenting your post by stating that clomid (alone) can increase the miscarriage rate even further….is probably a matter of semantics. Speaking of semantics, I think we are misunderstanding each other when referring to "egg quality". To me, "egg quality" is the inherent quality of eggs *before* stimulation. In this sense, I don’t think anything can improve this quality. However, once the follicle becomes stimulated, the egg quality can be harmed by things such as excess LH (or androgens) …therefore decreasing the *ultimate* quality, upon ovulation. Semantics, again…… (forgive me if none of this makes sense….) <<My RE has told me he has seen a marked improvement with PCO women undergoing IVF when they did take Metformin that cycle versus when they didn’t. He said egg quality improved greatly after taking Metformin. My RE disagrees (oh well…). Then again, your RE has tried it, and mine hasn’t. I am an IVF patient, and asked if metformin would help. He said that metformin has not been "proven", to his satisfaction, to have any beneficial effect in *IVF*, and he won’t allow me to use it. I have severe PCOS. It’s bad. My androgens are waaay up there, and I have not ovulated on my own in over 19 years…I even went 15 years without a single period. However, my egg and embryo quality (and quantity), as demonstrated by IVF, has been fantastic. Go figure…. (maybe I’m a freak??….lol)
Response:
Hi all, I posted here a few months back. I’ve been taking a little break as I awaited my first RE appointment. The appt. was Monday and I finally have a diagnosis. My anovulation is not from stress, it’s PCO. I was surprised to see the classic string of pearls cycsts on my ovaries on the u/s. Luckily, I do not have any of the other PCO symptoms. I was glad to finally have an answer and a plan of action to help me conceive. But, I am terrified. We have been trying to conceive for 14 months. We have had one devastating miscarriage and my RE mentioned that people with PCO have a higher rate of m/c. Ugh! Anyway, he prescribed clomid 100 mg days 3-7 and an u/s 4-5 days after last pill to check CM and follicle development. I am psyched about this. I endured 2 unmonitored, unsuccessful cycles of clomid 50 mg. My OB insisted that there was no reason to monitor me since I had conceived earlier this year. Wrong! Anyway, I have posted on the PCO board and got no responses. I am looking for any info., suggested reading, personal stories about trying to conceive with PCO. Thanks so much for ANY input. Kim
Response:
<< I have posted on the PCO board and got no responses. I am looking for any info., suggested reading, personal stories about trying to conceive with PCO. You can email me, if you like (I have PCOS, and a looong personal story!). Here are some websites: http://blues.fd1.uc.edu/~gartsips/polycyst.htm http://www.pcosupport.org/ http://www.pcosupport.org/pcosinfo/facts.html http://www.nejm.org/content/1999/0340/0003/0177.asp http://php.silverplatter.com/physicians/opinions/A50380.htm
Response:
We have had one devastating miscarriage and my RE mentioned that people with PCO have a higher rate of m/c. Ugh! Anyway, he prescribed clomid 100 mg days 3-7 and an u/s 4-5 days after last pill to check CM and follicle development. I am psyched about this. I endured 2 unmonitored, unsuccessful cycles of clomid 50 mg. My OB insisted that there was no reason to monitor me since I had conceived earlier this year. Wrong!
Kim, I too have PCOS and I’ve had 3 m/c. Ugh! is right!!! My RE also told me PCOS women have higher rate of m/c, he thinks due to poor egg quality. I too had several unmonitored Clomid cycles. (five to be exact) What a waste of time and emotions. I then transfered to RE and got diagnosis of PCO. Did two more cyles of Clomid with Prednisone and still no ovulation. (I guess you know most PCO women are resistant to Clomid when taken alone). I’ve had 4 IUI’s, conceiving thru 2 of them. After my last m/c in September RE suggested trying Metformin and if I didn’t ovulate just on that we’d combine it with Clomid. Well, I only ovulated once on Metformin alone so we combined it with 100mg Clomid this cycle and I ovulated! Yipeee!! IUI’s are a little scary for me because no matter how little of the injectibles I’m given I produce a multitude of follicles. Anyhow, I have a little more hope that my egg quality will improve on the Metformin and that my next pregnancy will be successful. Kay(EDEK) has already sent you all the good web addresses. If you have anymore questions, please feel free to e-mail me. Nicole
Response:
<<I too have PCOS and I’ve had 3 m/c. Ugh! is right!!! My RE also told me PCOS women have higher rate of m/c, he thinks due to poor egg quality. I don’t think you can really change your egg quality….your eggs are your eggs. The thing with miscarriage and PCOS is mostly clomid-related, I believe. That is, clomid elevates LH. With PCOS, we have too much LH in the first place. Adding more LH (w/clomid) can cause premature egg degeneration…the egg starts to mature too early, before ovulation. If it does fertilize and implant, it might not be viable or have enough "energy" left to thrive. In *that* sense, clomid (alone) can diminish egg quality, by causing them to mature too early. -K
Response:
<<I too have PCOS and I’ve had 3 m/c. Ugh! is right!!! My RE also told me PCOS women have higher rate of m/c, he thinks due to poor egg quality. I don’t think you can really change your egg quality….your eggs are your eggs. The thing with miscarriage and PCOS is mostly clomid-related, I believe. That is, clomid elevates LH. With PCOS, we have too much LH in the first place. Adding more LH (w/clomid) can cause premature egg degeneration…the egg starts to mature too early, before ovulation. If it does fertilize and implant, it might not be viable or have enough "energy" left to thrive. In *that* sense, clomid (alone) can diminish egg quality, by causing them to mature too early. -K
The three pregnancies I did achieve were not from Clomid. One was a spontaneous ovulation and the other two were injectibles/IUI. It was my understanding that being on the Metformin helped lower the androgen levels so that the egg had a healthier environment in which to grow. Is this not your understanding as well? My RE has told me he has seen a marked improvement with PCO women undergoing IVF when they did take Metformin that cycle versus when they didn’t. He said egg quality improved greatly after taking Metformin. Nicole
Response:
Filed under: PCOS
Leave a Comment
XHTML: You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>
TrackBack URL | RSS feed for comments on this post.