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Should I stop Metformin when I am pregnant? History of PCOS

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Infertility Specialist
Practicing since : 2000
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Question: Is it required to stop meformine in pregnancy for women with PCOS history? Any other suggestion ?
Detailed Background below ( see attached document for reports and treatement history )
My wife (AGE 26+, Height 165 cm, Weight 64 Kg ; reduced from earlier 69.5 Kg in one year with Meformine 2*500 mg daily ) is in her early pregnancy (26.08.12 ,38th day from last cycle ).
She has problem of PCOS since last two years. Her periodic cycle changed to an approximate interval of 3 months from normal one month since Aug-2010. Doctor prescribed Metformine (2*500mg/day) starting from April-2011 after confirmation of PCOS. This delay for confirmation was caused by change of doctors for change of location.
In May,2011 one try for pregnancy (HMG injection for follicle maturity and some injection(name ?) for ovulation/egg release ) was unsuccessful. In June-2011 follicle was not mature even after HMG injection.
From July,2011 she was under continuous birth control pills till ( 1*21 days for first two months with Krimson 35 which contains Cyproterone Acetate and Ehinyloestradiol , then continuously everyday for next 9 months with Valette which contains 0.03 mg ethinylestradiol, dienogest 2.0 mg ) till mid-June 2012.

Starting from June-2012 we tried for pregnancy for two consecutive months with Clomid (for 5 days 1*500mg ) and injection for ovulation. The second month try was successful, she was tested +ve for pregnancy and doctor suggested to take Projesteron 2*200mg daily for one month. She also took the same projesteron for 10 days(14th - 23rd day ,2*200mg daily orally ).
During our last visit (22.08.12) the doctor suggested to stop the Metformin immediately but agreed to continue till the next sonography (scheduled on 44th day from last period i,e 01.09.2012 ) when we told her again about the problem history of PCOS.

We understand that there may be some justification in doctor’s mind for her suggestion to discontinue metformine.

On the other side, We also saw in some internet information and some health forum that meformine helps to reduce the chances of miscarriage for the patients with PCOD history. Please give your opinion.

I am little worried since we are visiting this doctor only from last one month (had to change because of residence change for work location change ) and I felt that the doctor is not very interactive and not much interested to answer our questions. We trust our doctor but a second opinion will really help us to get convinced for discontinuing metformine.
Also please give any other valuable suggestion if any.
Thanks for your answer.
Posted Sun, 16 Sep 2012 in Infertility Problem
Answered by Dr. Mahesh Koregol 6 hours later
Hi, thanks for query. I read your query & saw the attached report. Following s my reply : 1) Congratulations on your wife getting pregnant. I appreciate the discipline of maintaining records done by you. 2) Dont stop metformin.It helps in reducing insulin resistance & hence helps in more than one way in PCOS patients. 3) It is known to reduce miscarriage. 4) Earlier there was fear that metformin leads to congenital malformatins in baby. Thus some doctors advice you to stop metformin. 4) Recent medical research & evidence have disproved this theory and thrown light on continuing drug in pregnancy. 5) Hence i advice you to continue metformin till 12 weeks of pregnancy which is crucial age for miscarriage. I hope i answered your query. Dr. Mahesh Koregol. IVF & Infertility specialist.
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