Miscarriage and PCOS

[lucysnowe]

Hi all

I wondered if there was anyone out there who has PCOS and also problems with recurrent miscarriage - and if taking metformin helped?

I ask because I took metformin the first time around, and had a successful pg. This time I didn't, and m/c quite recently. My cycles are more regular now, and my BMI is alot less, but DH thinks I should ask the GP if I can go on metformin again. Any advice really appreciated.

Hi Lucy

I am not an expert but I do have PCOS and miscarried my first pregnancy at 10 wks about a year ago. I was prescribed Metformin by a private Endocrinologist last summer to treat the PCOS (even though I was a healthy BMI - and am now even skinnier) and he advised me to keep taking it after I got a BFP until 16 weeks. So I am now pregnant again (6+5) - don't know if this one will stick, but am giving the metformin a try. There are some studies which show that it can lower the risk of mc in PCOS women, but the evidence is contested and every dr has a different opinion. I definitely think it is worth discussing with your GP and/or Gynae/fertility specialist, if you're under the care of one.

Good luck.

Can I ask what dose of metformin you both take per day when pregnant? I am not pregnant but currently take 1500mg a day. All doctors, consultants have told me to stop taking it when pregnant but I am keen to continue as I've heard it reduces the chance of miscarriage and there is no evidence that it harms the baby.

Hi Lubyloo

I have continued on my dose of 1500mg a day while pregnant. Just saw the heartbeat on a 7 wk scan - this is further than we got last time (although it was a missed mc so not diagnosed til 10 wks). Drs really seem to have very different opinions on this, but lots of women with PCOS take Metformin in pregnancy and there is no evidence of any harm - in fact it reduces your risk of gestational diabetes which is also associated with PCOS.

Best of luck

Congratulations on seeing a beautiful heartbeat! That's great news. Thanks for the info. I couldn't get an answer from my doctor as he just kept saying I shouldn't take it in pregnancy.

Wishing you a happy, healthy pregnancy.

Thanks 2nd and luby for your answers and congrats 2nd!

luby, the first time around I took met up to about 12 weeks and I think gradually reduced it from 1500 to 500mg. This was partly because I keep on forgetting to take it.

2nd that is v. interesting because a friend of mine who is a little underweight wasn't given metformin, even though her PCOS is pretty severe and she has been TTC for ages. That gives me hope that maybe my sympathetic doc may prescribe it again, as I'm not underweight at all.

I have been looking at the verity board, www.verity-pcos.org.uk and it seems that a recent study suggested that metformin didn't really have any affect on PCOS at all... but anecdotally it seems to have worked for lots of people (me included), certainly in TTC if not in avoiding m/c. 2nd I hope it works for you!

Sorry to hear about your recent miscarriage.

I had five miscarriages, after a lot of tests, and more than one consultant I was finally diagnosed with PCOS and prescribed metformin. It wasn't until my ovaries were scanned that this was diagnosed- I had none of the usual symptoms except a quite long cycle. I too had a healthy BMI. It is now all a bit of a blur but this consultant explained that PCOS is not straightforward and in his opinion it can increase your risk of miscarriage for two main reasons- firstly your hormone balance can be affected and secondly your egg quality can be affected. He felt that metformin could help and advised me to take it for 3 months before trying again.

I did this and finally had a sucessful pregnancy resulting in our wonderful DS (2.10). I took the metformin for my first trimester, this raised a few eyebrows from GP and midwives who said they thought it should not be taken in pregnancy. However, they went with it as the consultant who prescribed it was the head of O&G, he said it was not on the list of medications safe for pregnancy, but was safe in his opinion.

Its impossible to say if it really helped, and I don't want to give the impression that all women with PCOS are going to suffer miscarriages, or that they should take metformin. I am not an expert but am just giving you my experience to add to the mix.

Best of luck.....

Thanks, wmp.

I think the risk of m/c is supposed to be increased with PCOS but this may be because more ladies with PCOS take clomid which I've read also increases the risk - hope I'm not completely talking out of my bottom here.

I've heard abut the hormone issue (increased testosterone?) but not egg quality, which is interesting.

Really interested to hear your story, and so pleased it worked out for the birth of your DS.

I think I may see what my cycles are like to see if I have a case to bring to the doc...

Hi Lucy,
I think the egg quality thing might be related to the fact that an egg released in a longer cycle may be of poorer quality than that of a more regular 28day type cycle as it has taken longer to 'mature'. However, its possible I may be talking out of my arse also.

It was the appearance of my ovaries on a scan that made the consultant decide I had PCOS. The possibility had been dismissed outright by other doctors (who didn't do a scan)because I didn't tick the right boxes.

There are so many variables, theories and conflicting research out there that its really hard to see the wood for the trees.

If its on your mind maybe you could discuss it with your doctor and ask him/her if they would consider offering it to you.

Hope all works out for you......

HIall. i was diagnosed with pcos in december and found out i was pregnant about a week later. had mmc last week (wed 10th feb). this was my first pregnancy at 22yrs old and wondered how many of you think that your pcos caused your mc? i had mmc at 12weeks and sonograoher couldn't give me an idea of what exactly went on as there was no 'foetal matter' there.
i'd greatly appreciate some advice from those of you who have lived with pcos for longer than i have. also any stories of those who have had mc/mmc and have pcos who have gone on to have succesful pregnancy without taking medication?

Thanks very much xx

Hi MrsB

Very sorry to hear about your MMC. I'm not sure if the PCOS was a cause of my MMC TBH - there are plenty of other reasons why it may happen - sometimes it's just one of those things. You may find the verity site useful:

www.verity-pcos.org.uk

they have a discussion board with a miscarriage section that you might find useful (I'm going to have a look too!).

I did however find taking metformin helpful, I think it did help me TTC and gave me some reassurance during early pregnancy.

wmp - that's really interesting, thankyou. Like you I don't have many PCOS symptoms but I did have lots of cysts. The problem with PCOS I think is that it's merely the name for a combination of symptoms and there's not one underlying cause. Hence, as you say, all the different theories out there...

MrsBeeb sorry for your loss. I think it is really impossible to say whether your mc was caused by the PCOS, or just a coincidence. I had a mmc - a blighted ovum, which is where to sac develops but there is no baby inside - a year ago, and both my Endocrinologist and my Gynaecologist said it was quite likely that it wasn't even related to the PCOS, since these can happen randomly to anyone and are normally caused by a chromosomal problem that is unlikely to recur.

Lucy and wheresmypaddle, I've also tried to read up on PCOS-related mc to see what can be done to prevent it, but the info is all so confusing, I've come to the conclusion that no-one really knows for sure why PCOS may sometimes be related to higher mc risk. Egg quality and hormones are related, since if you're hormones are out of whack, you're more likely to release poor quality eggs. If you look at Lesley Regan's book on mc, she talks about the hormonal imbalances that PCOS causes, esp. raised LH - but when they used drugs to suppress women's LH levels, it made no difference at all to the mc rate. My Gynae (who's pretty good and specialises in PCOS) is of the opinion that most PCOS related miscarriages are actually linked to insulin problems - many PCOS women are insulin resistant - and excess insulin can cause blood clotting and other problems. Metformin definitely helps with this, and my Endocrinologist advised that (before pregnancy) it can also help with balancing hormones (lowering testosterone and LH) and improving egg quality. I have seen the study on Verity which claimed it makes no difference, but this is just one study among countless others and the evidence seems to be divided kind of half and half, so I came to the conclusion that I really just had to try it for myself to know if it would help me.

Was wonderful to see the heartbeat but am just as anxious about the next scan in 2 weeks.

Best of luck everyone.

2nd, that is really, really useful, thankyou so much! I think I will def take this up with my doctor.

Thanks Lucy and 2nd. i will try and get in to see my endocrinologist to have a chat over things with him.
It means a lot to have support of others so thank you.

Best of luck to all others and maybe catch up on the ttc threads soon!

xx

You too MrsB! xx