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When To Start Metformin For Fertility

Fertility Treatment

Fertility Treatment

Glucophage (Metformin) for the Treatment of PCOS Polycystic ovary syndrome (PCOS) is a common condition characterized by failure to ovulate (and irregular menstrual periods), a tendency toward excess body hair and acne and/or oily skin. It is estimated that one in twenty reproductive age women have PCOS. While this is a common problem in the infertile population, the cause of this condition is still not completely understood. There is new information to suggest that the underlying cause in many women with PCOS is insulin resistance. Women with this condition are not diabetic-their blood sugar levels are normal-however, their insulin levels are frequently elevated. Lowering the insulin levels acts to decrease elevated levels of male-type hormones (such as Testosterone) and, in many cases, restores ovulation and normal fertility. Treatment of infertility for women with PCOS is ovulation induction with clomiphene citrate (Clomid, Serophene) and/or metformin. For those who fail to ovulate in response to clomiphene citrate alone, treatment with Metformin may be added. Metformin does not have a F.D.A. indication for its use in PCOS but there is substantial research on the application of Metformin in this setting and Metformin is being used at reproductive endocrinology and infertility clinics around the world for this common problem. Metformin has no effect on insulin production per se but facilitates insulin action in the body so that the body will naturally make less of it. It should not be used in women with insulin-dependent diabetes, liver dysfunction, kidney disease, or who are exposed to IVP dye (for X-ray testing of the kidneys). It should not be used in times of acute physical stress such as severe illness (influenza), surgery or recovery from significant trauma. Deh Continue reading >>

Polycystic Ovarian Syndrome Fertility Treatment With Metformin (glucophage)

Polycystic Ovarian Syndrome Fertility Treatment With Metformin (glucophage)

How Metformin Is Used for Polycystic Ovaries Polycystic ovarian syndrome is a common cause of anovulation and infertility in women. These women do not ovulate (release eggs) regularly and therefore have irregular menstrual periods. The ovaries have many small cysts (2-7 mm diameter) called antral follicles, giving the ovaries a characteristic "polycystic" (many cysts) appearance on ultrasound. A relatively new method of treating ovulation problems in women with polycystic ovarian disease is to use an oral medication called metformin (brand name is Glucophage). Metformin has traditionally been used as an oral drug to help control diabetes. Then, some smart doctor figured out that polycystic ovarian syndrome treatment with metformin can be very effective. If Glucophage alone does not result in ovulation and pregnancy, we often use: If the combination therapy is not effective, we can try: Metformin Use with IVF Treatment We also use Glucophage in women going through in vitro fertilization for PCOS, and for those with very high antral follicle counts - if their ovaries are "polycystic" by ultrasound. We find that some women with polycystic ovaries respond with a "smoother" response to the injectable FSH medication if they have been taking Glucophage. Risks and Side Effects of Metformin / Glucophage In about 25% of women Glucophage causes side effects which may include abdominal discomfort, cramping, diarrhea and nausea. The side effects may be severe enough to make the woman stop the Glucophage medication. We are not aware of any serious complications resulting from Glucophage treatment. Another oral medication used for diabetes called Troglitazone has been associated with liver failure and death in rare cases. This has been publicized on television shows, in newspapers, et Continue reading >>

Can Metformin Help Women With Pcos?

Can Metformin Help Women With Pcos?

Home / Fertility / Boosting Fertility We asked doctors whether the drug Metformin really helps women with PCOS conceive, reduce miscarriage risk and increase milk supply. Here's what they say. If you have polycystic ovary syndrome (PCOS), you're not alone. According to the National Center for Biotechnology Information , this hormonal disorder affects between 5 percent and 15 percent of women of reproductive age in this country. In polycystic ovary syndrome, cysts develop on the ovaries, and the body produces excess hormones called androgens, which cause an irregular menstrual cycle. As a result, ovulation can be unpredictable, and getting pregnant can be challenging. "Since puberty, I've averaged one menstrual cycle per year," says Carrie, a mother from the Midwest who has PCOS. "I always wondered if I could have children." Carrie tried getting pregnant for several months, but wasn't able to because she wasn't ovulating. After evaluating her bloodwork, her OB/GYN suggested she go on either Clomid or Metformin to help balance her hormones to promote ovulation. "Because I had a very slight imbalance in my hormones, my doctor suggested trying Metformin before going straight to Clomid. Since I heard horror stories about Clomid causing multiples, I was happy to try Metformin first," Carrie says. Metformin is a diabetes medication that is sometimes used to regulate hormones in women with PCOS by balancing their insulin level. This effect leads to more regular menstruation and ovulation cycles , according to WebMD . Carrie got pregnant the first month she took Metformin. But not all women with polycystic ovary syndrome have such good results. In fact, experts say more evidence is needed to prove that Metformin helps conception in PCOS patients . "When putting all the data tog Continue reading >>

Metformin - Trying To Conceive - Essential Baby

Metformin - Trying To Conceive - Essential Baby

I have recently been diagnosed with PCOS after TTC for 16 months. And my gyno prescribed me with Metformin, has anyone taken this or is anyone taking it at the moment id love to know side effects / success stories... Hi! I was put on metformin a few years back due to pcos - i am now off it as pregnant i had it to help with insulin and other hormonal effects but my fertility specialist also said when i was ttc it would increase chances of falling pregnant and decrease chances of loss. I always had a couple of ginger pills half an hour before taking it for the first few weeks - had the slow release and took overnight. i was fine though i discovered if i took nurofen they clashed and had me running to the toilet. Hi, I suffered from secondary infertility - turns out I too had PCOS, insulin resistance, hormones out of whack (and some other stuff) - my OB/GYN put me on metformin, I also lost a bit of weight and followed a low GI diet. Thisfixed the insulin resistance and regulated my hormones and I fell pregnant. I stayed on the metformin for my entire pregnancy. It all went well. Good luck! Hi, I have PCOS and have used Metformin including a recent baby this year.I have all the symptoms and it does take me longer to get pregnant. But I have got 5 kids! For the last two pregnancies I couldn't get pregnant without Metformin. It usually takes a couple of months to be fully effective. Also prior to this new baby I had MC as didn't bother taking the Metform. Stupidly thought I could do without it. So went back on Metformin and had my new baby this year. Thanks for your replys may I ask how long it took to fall pregnant after starting metformin? I tired for 4 years for our 3rd and in that time and the following 2 years after that (so 6 years) had 4 early losses as well. Last yea Continue reading >>

Pcos: Insulin And Metformin

Pcos: Insulin And Metformin

Young women with PCOS often have elevated insulin levels and are more likely to develop diabetes. Metformin is a medication often prescribed for women with PCOS to help prevent diabetes. A lifestyle that includes healthy nutrition and daily exercise is the most important part of a PCOS treatment plan. What is insulin? Insulin is a hormone made by an organ in the body called the pancreas. The food you eat is broken down into simple sugar (glucose) during digestion. Glucose is absorbed into the blood after you eat. Insulin helps glucose enter the cells of the body to be used as energy. If there’s not enough insulin in the body, or if the body can’t use the insulin, sugar levels in the blood become higher. What is insulin resistance? If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. Insulin resistance tends to run in families. What can insulin resistance do to me? High insulin levels can cause thickening and darkening of the skin (acanthosis nigricans) on the back of the neck, axilla (under the arms), and groin area. In young women with PCOS, high insulin levels can cause the ovaries to make more androgen hormones such as testosterone. This can cause increased body hair, acne, and irregular or few periods. Having insulin resistance can increase your risk of developing diabetes. How can I lower my insulin levels? You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydr Continue reading >>

Does Metformin Make You More Fertile?

Does Metformin Make You More Fertile?

It's an increasingly common phenomenon: A drug that was originally synthesized for a specific purpose turns out to be effective in combating another problem. Examples include Viagra (an unsuccessful treatment for angina that succeeded as an erectile dysfunction drug) and Thalidomide, a disastrously ineffective medication for pregnancy-induced nausea that has been proven to fight bone marrow cancer [source: Brown]. Metformin can also be included in this list, but with one significant difference. Not only is it helpful in a secondary role, but it's wildly popular in treating the condition for which it was initially intended. Metformin was developed in the 1950s as a treatment for diabetes [source: Diabetes Forecast]. Today it's the most popular drug on the market for people with Type 2 diabetes [source: Science Daily]. But by 2004, Metformin was receiving international acknowledgement as a worthwhile option for patients seeking a remedy for their infertility. The U.K.'s National Collaborating Centre for Women and Children's Health noted that the drug, when used in conjunction with other medications, improved the rate of pregnancy in women with specific infertility issues tied to ovaries containing multiple cysts [source: NCCWCH]. The common denominator between Type 2 diabetes, Metformin and infertility can be described in one word: insulin. Insulin carries blood sugar to the body's cells to create energy. Some people's bodies, however, produce too little insulin, or the cells in the body refuse to accept the sugar it's transporting [source: American Diabetes Association]. That can lead to a multitude of health issues. Women whose infertility is tied to polycystic (multiple cysts) ovarian syndrome often have issues with insulin resistance. That's where Metformin comes in. Continue reading >>

How Long Does It Take To Get Pregnant With Metformin For Pcos Woman?

How Long Does It Take To Get Pregnant With Metformin For Pcos Woman?

Metformin is a multiplier. It can treat insulin resistance, if you have it, and help you lose weight. (In my case, mostly by making me too nauseous to eat.) Both things can make you slightly more likely to ovulate. It also decreases your risk of developing diabetes in the future. However, metformin alone isn't a fertility treatment. It is usually combined with other drugs, like Clomid, Femera, or injectable medications, to stimulate ovulation. Your doctors may try you on metformin alone for a short period of time, usually 3 months or less. If you don't become pregnant after that, they'll usually start the other medications. The bad news is that no one can predict exactly how long it will take you to get pregnant. This is one of the worst parts of infertility. I have been through it. The intense frustration of not knowing how long I would have to keep trying drove me nuts. The good news is that PCOS is very treatable. If your doctors are willing to start with just metformin, then your case is probably also fairly mild. For younger women with PCOS, success rates are very high. Hang in there! And yes, metformin is terrible. You aren't imagining how bad you feel. The side effects will probably let up shortly. If you feel really exhausted, ask your doctor about adding a B12 supplement to your diet. Metformin causes a B12 deficiency in about 30% of patients[1], which can make you feel tired. Continue reading >>

Metformin And Pcos: Everything You Need To Know

Metformin And Pcos: Everything You Need To Know

Metformin is a type of medication used to treat Type 2 Diabetes. Because there is a strong link between diabetes and PCOS, metformin is now commonly proscribed to treat PCOS. But should it be? What is the real relationship between metformin and PCOS? Can Metformin used for PCOS help lessen PCOS symptoms? Metformin used for PCOS: The Science PCOS is an infertility condition that often causes acne, facial hair growth, balding, low sex drive, weight gain, difficulty with weight loss, and mental health disturbances such as depression and anxiety in approximately 15% of women. It is also associated with a myriad of health conditions, spanning from diabetes to hypothyroidism and to heart disease. PCOS is, in short, not a condition to sneeze at. PCOS is a condition of hormone imbalance. With PCOS, male sex hormones such as testosterone and DHEA-S rise relative to the female sex hormones estrogen and progesterone. (…Roughly speaking – it’s complicated. For a full-blown account of the science of PCOS and how it affects you, see here.) Elevated testosterone is very often the primary culprit in causing PCOS. (But not always! For one of my most thorough accounts of other things that can cause PCOS, see here.) Insulin causes testosterone levels to rise because insulin tells the ovaries to produce testosterone. Basically, elevated insulin causes elevated testosterone, which causes PCOS. This is where metformin comes into play. Metformin lowers blood sugar levels below what they would otherwise be after a meal. This is because it intervenes with the liver’s interaction with and production of glucose. Insulin is the body’s way of dealing with blood sugar. If blood sugar is lower, then insulin will be lower, and thus testosterone will be lower. Metformin decreases blood sugar, Continue reading >>

Pregnancies Following Use Of Metformin For Ovulation Induction In Patients Withpolycystic Ovary Syndrome.

Pregnancies Following Use Of Metformin For Ovulation Induction In Patients Withpolycystic Ovary Syndrome.

Pregnancies following use of metformin for ovulation induction in patients withpolycystic ovary syndrome. Heard MJ(1), Pierce A, Carson SA, Buster JE. (1)Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas 77030, USA. Comment in Fertil Steril. 2002 Oct;78(4):890; author reply 890-1. OBJECTIVE: To assess pregnancy outcome in anovulatory infertility patientsdiagnosed with polycystic ovary syndrome (PCOS) who were treated with metformin.DESIGN: Case series.SETTING: Outpatient.PATIENT(S): Anovulatory patients (n = 48) with a diagnosis of PCOS based onclinical, diagnostic, and laboratory evaluations were enrolled in the study over a 15-month period.INTERVENTION(S): Metformin was started at 500 mg b.i.d. for 6 weeks and thenincreased to 500 mg t.i.d. if no ovulation occurred. Clomiphene citrate (CC; 50mg) was added if no ovulatory response occurred after 6 weeks.MAIN OUTCOME MEASURE(S): Resumption of menses, presumptive ovulation, andpregnancy.RESULT(S): Nineteen of 48 (40%) patients resumed spontaneous menses followingtreatment and showed presumptive evidence of ovulation with metformin alone;15/48 (31%) required CC (50 mg) in conjunction with metformin therapy, and 10 of these 15 (67%) had evidence of ovulation; 20/48 (42%) conceived with a mediantime to conception of 3 months, and 7 of these 20 (35%) had spontaneous abortions(SAB); 19/48 (40%) had gastrointestinal-related side effects, and 5 of 48patients (10%) had to decrease the dosage of metformin. Only 1 patientdiscontinued therapy.CONCLUSION(S): Metformin alone in patients with PCOS results in a substantialnumber of pregnancies, with 69% (20/29) of those who ovulated conceiving in less than 6 months. Continue reading >>

Metformin And Pcos

Metformin And Pcos

Metformin is used to treat patients who suffer from PCOS. Find out how Metformin can aid in conception by helping to regulate your ovulation and menstrual cycles. You might already know Metformin as Glucophage, a brand name drug used to treat patients who suffer from type 2 diabetes. However, what you might not know is that Metformin is also used as one of the most effective fertility drugs for women who are suffering from PCOS conceive more easily. Claim Your 20 Free Pregnancy Tests – Click Here Even for women who are not diabetic, Metformin can help lower insulin levels in order to regulate a woman’s menstrual cycle. It is common knowledge that PCOS can cause an excessive amount of androgens, or male hormones, in the body. Metformin is able to help lower that level of male hormones and help resume normal ovulation cycles as well as menstrual cycles in women who have PCOS. Metformin is usually used as a second round of treatment if the first round treatment options (usually Clomid) prove to be unsuccessful in helping to resume ovulation. Metformin has been proven not only to be a very popular, safe and effective drug for treating patients with diabetes, but also for women who have a problem keeping their insulin and blood sugar levels in check due to their PCOS as well. Metformin has also been proven to help women who are overweight as well as women who have normal body mass index levels. It seems that when Metformin is used, almost everyone can benefit from it. What Metformin does is to help balance insulin levels in the body. Since women with PCOS often have elevated insulin levels, Metformin can help to bring those levels back down to a normal level. Once the insulin levels are back down to normal, the male hormones (also known as androgens) also go back down to Continue reading >>

Opinion Article The Role Of Metformin In Ovulation Induction: Current Status

Opinion Article The Role Of Metformin In Ovulation Induction: Current Status

To define the exact role of metformin in ovulation induction, it is crucial to distinguish three different indications: naïve PCOS, CC-resistant PCOS and ART. In naïve PCOS: metformin as compared to placebo has been shown to improve ovulation rates, but metformin did not exert significant advantage over CC with respect to cumulative ovulation, pregnancy or live-birth rates. The combined approach of metformin plus CC is not better than CC or metformin monotherapy in naïve PCOS. In CC-resistant patients: metformin has no benefit over placebo in ovulation, pregnancy, and live-birth rates as a single agent, but the combination of metformin and CC significantly improved ovulation and pregnancy rates when compared with CC alone. However, combined therapy did not improve the odds of live birth. Metformin pretreatment improves the efficacy of CC in PCOS patients with CC resistance. In PCOS patients scheduled for ART: metformin addition to gonadotropins reduces the duration of gonadotropins administration and the doses of gonadotropins required, and increases the rate of monoovulations, reducing the risk of cancelled cycles. Metformin co-administration to IVF treatment does not improve pregnancy or live-birth rates but reduces the risk of OHSS. Continue reading >>

Pcos And Metformin – Is This Treatment Right For You?

Pcos And Metformin – Is This Treatment Right For You?

Here at Flo Living headquarters I speak with many women suffering with PCOS who have either been offered Metformin and decided against it or have tried Metformin and it’s not worked for them. If you have a diagnosis of PCOS it’s very likely that at some point your doctor has suggested Metformin. I personally was what would be considered the “perfect” candidate for this treatment when I was in my 20s and suffering with PCOS – overweight, struggling with acne and a complete lack of periods. However, I never tried it myself – instead I created a protocol for myself that became Flo Living. I’ve since helped many women manage their PCOS successfully with this protocol, just as I did my own diagnosis. That said, I speak with women so often about the Metformin option that I want to share my perspective with you. Although I do not dismiss the option completely, I do have some caveats and concerns. What is Metformin? Metformin is a first-line medication for those suffering with type 2 diabetes. It is also presented as a treatment for PCOS sufferers who are also overweight or obese. Not all PCOS sufferers have weight gain as a symptom, it depends on the kind of PCOS. Women with the kind of PCOS that causes weight gain are usually insulin resistant. Metformin reduces overall insulin levels. Insulin resistance is when the cells of your body become resistant to the hormone insulin, preventing glucose from entering your cells to be used for energy, and instead causing soaring levels of sugar blood stream bringing about diabetes, pre-diabetes or insulin-resistant PCOS. The connection between insulin and PCOS is blood sugar regulation. We hear about this most commonly with diabetes, but it’s also very important with PCOS. An unstable, constantly spiking and crashing, bl Continue reading >>

How Long Does It Take For Metformin To Work For Conception?

How Long Does It Take For Metformin To Work For Conception?

Metformin, also known as Glucophage, is a medication that is used to regulate the levels of glucose (sugar) in the blood. Metformin accomplishes its task through three methods. First, it causes the liver to produce less glucose. Second, metformin helps your stomach to absorb less glucose from the food that you eat. Finally, metformin improves the efficiency of the insulin that the body produces, which reduces the amount of glucose that is in your blood. Metformin is often prescribed for people with Type II diabetes. How long it takes Metformin to work depends on the reason that a woman is taking metformin. If a woman is taking metformin to regulate her blood sugar, metformin typically will work within a few days or a few weeks at the most. For the woman with polycystic ovarian syndrome (PCOS) metformin can help to reduce the amount of insulin in the body. Once the insulin levels are under control, many women will then experience improved ovulation. If metformin is going to work for a woman who has experienced fertility problems because of her polycystic ovarian syndrome, it will typically help within three to six months. Unlike most fertility treatments, metformin does not cause a risk of having a multiple or twin pregnancy. If metformin alone does not help a woman with PCOS who is trying to conceive, a fertility doctor may prescribe Clomid, as well. If metformin is prescribed for a woman with PCOS to help restore a regular, normal menstrual cycle, metformin can work within 4 to 8 weeks. In addition, the stabilized levels of insulin may affect the other hormones in a woman’s body, and reduce other symptoms of PCOS. Some women, either with diabetes or PCOS, use metformin as a tool for weight loss. If this is the case, weight loss can occur somewhere between 1 and 5 wee Continue reading >>

Role Of Metformin In The Management Of Polycystic Ovary Syndrome

Role Of Metformin In The Management Of Polycystic Ovary Syndrome

Go to: Background Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting 4–12% of women [Diamanti-Kandarakis et al. 1999; Farah et al. 1999; Knochenhauer et al. 1998]. It has also been the most controversial medical condition and every aspect has received a lot of attention from the nomenclature to the management. Several descriptions of similar conditions took place in the 20th century and it was named Stein—Leventhal Syndrome in 1935 after the authors who described polycystic ovarian morphology in patients suffering from hirsutism, amenorrhoea and infertility [Leventhal, 1958; Stein and Leventhal, 1935]. PCOS was also called polycystic ‘ovarian’ syndrome implying that the primary pathology lies in or triggered by the ovary. Others have called it polycystic ovary disease (PCOD), which is the least used term for obvious reasons. Currently, PCOS refers to a disorder with a combination of reproductive and metabolic characteristics. This has evolved over time with controversy over the definition culminating in the latest consensus [ESHRE/ASRM, 2004] which instead of solving the issue created more controversy [Azziz et al. 2006]. In the European Society of Human Reproduction and Embryology/American Society of Reproductive Medicine (ESHRE/ASRM) consensus, at least two of the following features are needed to make the diagnosis; oligo/anovulation, hyperandrogenism, and polycystic features on ultrasound scan [ESHRE/ASRM, 2004]. The Androgen Excess Society, however, recommended that androgen excess should remain a constant feature of PCOS irrespective of the ovulatory status and morphological features of the ovaries [Azziz et al. 2006]. For almost three decades, PCOS has been regarded as a life course disease which besides its reproductiv Continue reading >>

Metformin In The Treatment Of Infertility In Pcos: An Alternative Perspective

Metformin In The Treatment Of Infertility In Pcos: An Alternative Perspective

Metformin in the Treatment of Infertility in PCOS: An Alternative Perspective Departments of Internal Medicine, Obstetrics and Gynecology, and Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298 John E. Nestler, Departments of Internal Medicine, Obstetrics and Gynecology, and Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298; Address all correspondence and reprint requests to: John E. Nestler, M.D., Division of Endocrinology and Metabolism, Medical College of Virginia, P.O. Box 980111, Richmond, VA 23298-0111 The publisher's final edited version of this article is available at Fertil Steril See other articles in PMC that cite the published article. This editorial discusses the recent ESHRE/ASRM recommendations on the treatment of infertility in PCOS. Evidence is provided for the use of metformin in selected patients. In 2007, the European Society for Human Reproduction and Embryology (EHSRE) and the American Society for Reproductive Medicine (ASRM) sponsored a workshop to discuss the therapeutic challenges of infertility and the polycystic ovary syndrome (PCOS), out of which a consensus paper emerged ( 1 ). The consensus statement offered a bleak view of the use of metformin in infertility, recommending that metformin use in PCOS should be restricted to women with glucose intolerance. In this editorial, I offer a perspective on the use of metformin for the treatment of infertility in PCOS that differs significantly from the consensus statement. My aim is to provide a strategy that addresses the needs not only of the reproductive endocrinologist, whose patients often desire pregnancy immediately, but also the gynecologist, medical endocrinologist and others, whose patients' time lines for achieving pregnancy Continue reading >>

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