PCOS, pregnancy, and progesterone?

[LondonStill83]

Hi all,

I just found out I am pregnant- and am freaking out a bit! See my other thread on travel to India :-).

Anyway, I have PCOS and expected to have difficulties conceiving. However I came off the pill on 1 January and conceived almost right away, apparently.

I have read though that I have a higher risk of early miscarriage? I have also read that progesterone and metformin can help.

Does anyone have any advice or experiences with either? Seems hard to get progesterone in the UK?

[bluepuzzle]

I have experience of progesterone. I live in a country where it's prescribed very readily, though. I had one early miscarriage, and as soon as I became pregnant again I was prescribed the cyclogest pessaries, with no blood tests for progesterone levels or anything. Currently 35 weeks pregnant.

I have read of people getting it on prescription in the UK, although no idea how willing doctors are to give it. I'm not sure if it's even proven that it can help - I think it doesn't do any harm, though. It's definitely worth asking your doctor. (Mine was prescribed by an obstetrician - not sure how it would work in the UK.)

Congratulations on your pregnancy :)

[LondonStill83]

Thank you!

Might I ask what dosage and type you are on? I may be able to order it from the USA or get my mom to send me some from Canada?

[BettyBi0]

I have PCO and was on lots of Meds in pregnancy after multiple miscarriages. The IVF consultant explained to me that the metformin was more important in the 3 months leading up to conception as a way of protecting egg quality in the final maturation stage. I had hyperemesis at the time and couldn't keep down any pills in the first trimester but he said it really didn't matter after conception. He did advise to stick to a low GI diet though to help keep blood sugars stable in the same way as the metformin would have helped with. In the end all I could keep down was ready salted crisps and toast so that knocked that bright idea on the head!

The progesterone was just because it was an IVF pregnancy. There is very little evidence to support extra progesterone after regular conceptions unless the mum has proven low levels.

So in short, I wouldn't worry about trying to take any extra meds now and just try to enjoy your pregnancy. As far as I understand it, if PCO is going to increase chances of miscarriage, it's because of the potential damage to eggs pre conception

[bluepuzzle]

It's the Cyclogest pessaries, two a day (one on waking and one before going to bed), 400 mg each.

Have you been told no? You might find that your doctor will prescribe it - certainly safer than ordering online.

It's worth asking your doctor, or asking to speak to a consultant. People in the UK do get it prescribed, so you may well be able to.

[LondonStill83]

Thanks both.

I suspect that my anxiety is going out of control and so I am just looking for something- anything- I can control!

I will try the GP.- apparently my borough doesn't pay for it but I may be able to get a referral or pay privately I suppose.

It's all so overwhelming!

[spacefrog35]

Speak to your GP about your anxiety first. If you're anxious enough to consider self medicating prescription drugs during your pregnancy then getting that treated is a higher priority than any possible other concerns. Please don't misunderstand me, I'm not intending to be flippant or harsh on you but anxiety during pregnancy can be horrible. Get it recorded and treated as soon as you can.

[LondonStill83]

Space frog, that is a very very good point!!! I am on treatment for anxiety but will go into GP to address this assuming I can get an appointment tomorrow. You are right- I have gone from 0 to 60, as usual!

I think I am confused about it all. I have no idea how pregnant I am as I didn't have a period after coming off the pill, I am off to India soon, etc etc... Just a bit overwhelmed!

[spacefrog35]

Sorry for not coming back yesterday. Being overwhelmed and anxious is a really normal part of being pregnant but it's so easy to let it get out of control. The fact you know you need to chat to you GP is a really good sign that you're going to do fine at keeping it in perspective
Enjoy India - it's a fabulous place (although very hard to get your head around the culture sometimes)

[MetalMidget]

First of all, congratulations!

I have both PCOS and an underactive thyroid - I found out after trying to conceive for nearly two years. I was put on levothyroxine for the thyroid, and metformin for the PCOS (I was literally not ovulating).

The metformin was to help manage my insulin levels and weight, as one of the side effects of PCOS can be insulin resistance and weight gain - in the two years after coming off the pill, I piled on several stone in weight, which was extremely frustrating as my diet hadn't radically gotten worse, and I was doing more exercise (I'd put it down to my metabolism slowing due to getting older!). I had to lose weight before the NHS would consider fertility treatment (not unreasonable) - I lost a stone in two months after starting treatment, and ended up discovering that I was naturally pregnant the day before seeing the fertility consultant again!

I was told to carry on taking the metformin, so I don't know if it lowers the chance of miscarriage? I don't think the risk is hugely raised though, I know three other women with PCOS who have had trouble-free pregnancies, and I'm nearly on week 15, which I'm hoping is out of the danger zone!

I should warn you that metformin can be pretty brutal when you start it - normally you have to work up to the full dose, and it can cause quite bad stomach cramps and diarrhoea (which tragically may be partly why I had such spectacular weight loss so quickly!). I'm not sure they'd recommend starting it during pregnancy, and I'm not sure if you need it if you're of a healthy weight and pregnant!

[LondonStill83]

Thanks again for responding everyone.

I will call the GP tomorrow morning. After 48 hours of the shock alleviating somewhat, I am decidedly calmer now.

In terms of weight and pregnancy, I am overweight. A size 16 and 5"3 so not huge but not small either!

I was taking inositol, chromium, vitamin d to help reduce insulin resistance and lose weight. This was really helping, alongside cutting out dairy, gluten, and refined sugar.

Think will stay on the vitamin D and inositol and see GP about considering metformin or progesterone. The inositol should help with progesterone anyway...

It's a minefield, it really is!

[Basketofwool]

London I just wanted to pop in to say I also fell pregnant in the first month of trying despite being told I had PCOS 8 years ago. I've had 2 scans so far and asked the sonographers to have a look at my ovaries - neither could see any cysts so it might be that your PCOS cleared up somehow? Maybe no need to worry about hormones etc?
Hopefully your GP will help :)

[LondonStill83]

Ah thanks for this- I went to GP today and they've booked me a longer appointment on 13 Feb to discuss everything.

Suspect I will have an early scan so will know more then!

For now, it's just waiting, waiting, waiting!

[WombOfOnesOwn]

Inositol, an over-the-counter supplement, works as well as metformin without many of the side effects for many women. Please don't take my word for it (or any rando on the internet), though look at the peer reviewed research. scholar.google.com look for any combination of "inositol," "PCOS," "fertility," "pregnancy" and so on.

I say this because anyone telling me "oh, there's some supplement that's just as good" would elicit an eyeroll and a "next post, please" reaction from me. This is based on good research, though -- it's research that got me pregnant and has kept my blood sugar readings perfect throughout pregnancy (my midwives were astonished, as I am VERY heavy with a family history of diabetes from my mother and grandmother).

[tinyme135]

I have PCOS and apparently there was no way me getting pregnant without taking metformin and all that, but I have recently gave birth to my ds. I had a great pregnancy and didn't need anything with it, I was also under midwife led.

some people do have early miscarriages but don't read into it as all it will only stress you out.

and congratulations on your pregnancy :)

[LondonStill83]

Thanks womb- oddly I had already read up on inositol and figured it does pretty much the same thing as metformin, with the effects.

So, am taking it. Did you take 2 or3 pills a day!

And, thyme, thank you- I am trying not to worry and just to enjoy. Rarely, I succeed!

[Blackpoollassy]

Hi
There's no current evidence to say that progesterone supports pregnancy, even though it's routinely prescribed for IVF/IUI pregnancies.
You can ask for it but will likely be refused.
there is a trial on at the moment called PRISM (i'm on it) where you can get either placebo or progesterone of you've had early bleeding. You could see if your Trust is on the trial?
www.miscarriageassociation.org.uk/information/research/the-prism-trial/

As for metformin, there's no evidence either for that. It's seems to be split either way. You may struggle to get it as well.
I took it with my last pregnancy though as i was already on it.

You have my sympathies as i have asked all the same questions as you in the past and have just hit brick walls every time

[charlottexox]

Well first of all, congratulations on your pregnancy .
I also have PCOS and I do take metformin. The reason I got pregnant in the first place was thanks to metformin (yay!) I am currently only 11 weeks at the moment.
I was told to continue taking metformin because of my blood sugar levels, I read online that it can also help women who have PCOS and whom are pregnant so they do not miscarry.
I was told by my GP that the MW may tell me to stop taking it after 14-16 weeks if my blood sugar levels and weight stays OK.
I also know that if you take metformin during pregnancy you can develop diabetes in your pregnancy (there is a name for it, but my mind has gone blank!)
I am not too sure about the progesterone, but that's something I would be interesting in knowing about considering I have high levels of testosterone.
Anyway, try not to panic - anxiety isn't good for the baby or you .
Good luck x

[Raindrop25]

Can someone please help?

I have been taking clomid since March with no luck, I get my progesterone level checked on day 21 of my cycle each month to see if I ovulated. The past 2 months it has been a level of 45, however this month is 85! It's the highest it's ever been.

Is this a good result? Could it possibly be a sign of pregnancy? Any information would help please!!

Thanks