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On Metformin, birth control pill Novelon. Should i take folic acid and multivitamin tablets? How can i increase chances of conception?

I have been put on Metformin and birth control pill Novelon for past 3 months. TTC since 3.5 years and never conceived. No prob diagonised yet except high insulin levels due to which I started metformin. Still on met but now off the pill. Doc prescribed ovafar for 5 days. Wish to know if I should take folic acid and multivitamin tablets? What else can I do to increase my chances of conception...thanks.
Asked On : Thu, 18 Apr 2013
Answers:  2 Views:  163
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OBGYN 's  Response
Since you are on your way with treatment, you can add folic acid and multivitamin tablets. Timing of intercourse is important if all other factors like tubal patency and male factor have been cleared. Do not move after intercourse; lie still on your back if you have an anteverted uterus and lie prone if you have a retroverted uterus for at least half-an-hour. Do not use strong soap solutions to wash after the act. Have intercourse at least on alternate days during the fertile period, preferably with follicular monitoring. Hope you have got the necessary information. Good luck.
Answered: Thu, 18 Apr 2013
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General & Family Physician Dr. Nirmala P's  Response
thanks for asking in Healthcare Magic.

Metformin and Novelon (Desogestrel and Ethinyl Estradiol) are given in Poly Cystic Ovarian Disease (PCOD). In PCOD, the insulin levels are either normal or high but there is always insulin resistance (improper insulin action). There will be excess of testosterone (male hormone) and less estrogen contributing to irregular menstrual cycle and anovulatory cycles. Novelon regularises the menstrual cycle but inhibits ovulation.

Metformin not only reduces insulin resistance and improves its action, it also reduces the excess level of testosterone and increases estrogen levels thereby increasing the ovulation (by 70%) and improving pregnancy rate (by 30%).

Ovalfar (Clomiphene citrate) stimulates ovulation and increases the chances of pregnancy. Addition of Chorionic Gonadotropin on the last two days of the course ( 4th and 5th day) will further enhance your chances of conception. Initially it is given in the dose of 50 mg and if you don't conceive in 2 months time then the dose can be doubled every 2 months up to 200 mg.

Folic acid and Zinc has been proved to increase fertility by stimulating ovulation. You can take them daily and also include liver and green vegetables which are high sources of Folic acid in your diet.

I hope this is useful.
Answered: Thu, 18 Apr 2013
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