PCOS-DIET Messages for August, 2002: Re: Pregnancy

Re: Pregnancy

From: Renee (anonymous@obgyn.net)
Sat, 03 Aug 2002 14:27:06 -0700

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Heard et al. Fertil Steril 2002 Apr;77(4):669-73 They gave PCOS women met, and if they didn't start to ovulate, added clomid. In 40% ovulated on met alone. 42% conceived within 15 months of study. 69% of the conceptions were within 6 months. The miscarriage rate of all the women studied was 35%. High drop-out/drop-off-met rate.

CJ Glueck et al, J Invest Med 2000 He kept some women on met for the whole pregnancy, and stopped with pregnancy for others. 45% miscarriage without met, 9% with.

Jakubowicz et al. J Clin Endocrinol Metab 2002 Feb;87(2):524-9 The early pregnancy loss rate in the metformin group was 8.8% (6 of 68 pregnancies), as compared with 41.9% (13 of 31 pregnancies) in the control group (P < 0.001). In the subset of women in each group with a prior history of miscarriage, the early pregnancy loss rate was 11.1% (4 of 36 pregnancies) in the metformin group, as compared with 58.3% (7 of 12 pregnancies) in the control group (P = 0.002).

You're right, Victoria, that there are many, many causes for PCOS. But, is is plausable that met helps to stabilize out some of the other hormonal imbalances involved with unsuccessful pregnancies, just as it helps stabilize other hormones in non-pregnant women (improved ovulation, decreased hirsutism, etc.).

Victoria, I know you know the value of a control group. The Heard study you cite below may have been unfortunate in the population studied being particularly difficult to treat, by chance. Is this the same study as above? It didn't look at comparing Met to anything, really. It was more of an single group longitudinal study. The ones cited above aren't perfect either. But, they're fairly consistent in their findings.

Renee

Victoria wrote: >
> Supposedly Dr. Michael Heard of Baylor continued Metformin 'uncontrolled' and it
> didn't do anything for the pregnancy rate. I know we've talked about this
> particular one before. Dr. Perloe was the one who said this, but I haven't found
> anything in Pubmed about it. I think, but am not sure, SGI was the periodical it
> was to be published in. I haven't looked at SGI, but I know the information
> stuck out in my mind. I thought it was odd since I've heard the same thing you
> have Renee.
>
> There are other reasons for miscarriage than just insulin levels. In RL, I've
> seen women have to go farther than using Metformin for pregnancy help. I would
> also suspect that a comment made in one article I have might be true and that is
> that oral medications may have only so much of a length of effectiveness.
> (Yikes!)
>
> Victoria
>
> > From: Renee <rcordrey@earthlink.net>
>
> > Actually, it's the opposite. Women not on metformin have a much higher rate
> > of miscarriage, but when they take it, their miscarriage rate is about the
> > same as the general population.
> >
> > Renee
> >
> > anonymous@obgyn.net wrote:
> > >
> > > I read online yesterday while doing some research that woman who conceive
> > > using Metformin have a greater than 30% chance of miscarriage. Has anyone
> > > else heard this before? I was diagnosed with PCOS several years ago and have
> > > been on metformin for quite some time, still with no success at getting
> > > pregnant. I am curious why such a high rate of miscarriage comes from this,
> > > and if anyone else has been informed of this by their doctors or not? My
> > > doctor never mentioned anything like that about it before.
> > >
> > > Thanks for your input!
> > >
> > > Amber
>

-- -------------- Renee Cordrey, MSPT, MPH, CWS

---
Dwell in Possibility.
--Emily Dickenson

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