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Metformin for PCOFrom: ainsron@msn.comTue Aug 8 15:05:21 2000
I had a long-standing patient with chronic annovulation bring in a copy of Mark Perloe's article on PCOS, wanting to know if metformin was a better choice for her than clomid. She is 28 yo G3 P3, each pregnancy occurred after one cycle of Clomid. She has ~one cycle per year spontaneously and takes provera every 3-6 months when not trying to conceive. Lab workup before her first pregnancy showed normal androgens (1993) and I've just ordered a repeat hormone panel. TVUS today and in the past showed "classic" polycystic ovaries, ring of pearls, 8mm endometrium (LMP was 6 months ago). She has no significant signs of androgen excess, no acne, normal hair distribution, non-obese and uses occaisional bleaching of facial hair (no plucking, electrolysis, etc.) She was screen negative for DM during all three pregnancies and has a weak family hx of DM. My recommendation to her was to go with what had worked in the past, i.e., progestin withdrawl and clomid. Would there be any short or long-term benefit to offering this patient Metformin instead? If not, who would you offer it to? Thanks
-- Ronald E. Ainsworth, MD
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