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Re: To whoever gives the 93% stat ALL SHOULD READ THIS! NOT JUST THOSE TTCFrom: Red (anonymous@obgyn.net)Fri, 27 Sep 2002 11:40:02 -0500 (CDT)
Hi a wonderful MD from the Jewish Hospital of Concinatti sent me a collection of data in a paper he cowrote to help encourage my infertility doc to put me on metformin. It has clinical data results from numerous studies and states the results in terms of met alone vs. met/clomid or met/IVF or met stopped at pregnancy vs met continued through pregnancy. The numbers I think that were likely referred to here in the thread were that PCOS patients started on a minimum of 1.5 grams per day of metformin (by slow increases over weeks) have resumption of normal menstrual cycles "91% of women within 6 months, with many women having normal cycles by two months". It also talks of the use of metformin alone or with clomid or other medications or strategies like IVF and Wedge resection (noting that no head to head trials existed at the time of the publication)for those TTC and interms of effects on pregnancy. He states that 90% of PCOS patients in a study ovulated with met and clomid versus 8% who received a placebo and Clomid. A sudy of infertile PCOS patients showed that "4.2% became pregnant" with clomid "alone versus 65.2%" with clomid and metformin; and that "39% of women resistant to" Clomid "ovulated when given metformin". In patients who received metformin "before gonadotropin treatment"; "in the metformin group, fertlization rates (64% vs 43%) and clinical pregnancy rates (70% vs 30%) were increased" with conjunctive metformin therapy. He is careful to mention that there have been "38 open label and/or placebo controlled studies" to verify the use of metformin for restoring ovulation, insulin levels/ and conception. What I found particularly interesting was the comparison of staying on metformin through pregnancy versus stopping it once pregnant and the effects on the babies. "Metformin therapy during pregnancy in women with PCOS safely reduces first trimester" miscarriages "from 73% to 10%". In another study "metformin alone in patients with PCOS results in a substantial number of pregnancies, with 69% of those who ovulated conceiving in 6 months". Metformin significantly "reduced" the number of first trimester miscarriages "from 65% to 16%". "Metformin at conception and during pregnancy had no adverse effects on birth height or weight, compared to CDC normal neonatal populations, no adverse effect on infants' first year accretion of height and weight, or on infant motor and social development in the first year of life". Another thing I have been stuggling to understand is why it appears ALL PCOS patients benefit from metformin and the answer is that not only do many have increased levels of insulin or insulin resistance - it is believed that the others might very well have an alteration in how there body uses (metabolizes) insulin. In other words our bodies (those with PCOS) has a difference in how it uses insulin to store/ convert simple dietary nutrients into what we need to fuel our bodies. It is likely that close family relatives (male and female) possess this same dysfunction which can one day lead to all the bad effects (heart disease, high blood pressure, diabetes, high cholesterol) that altered insulin metabolism can cause. I know this has been long winded but Dr. Glueck supplied me with medical knowledge I need - and I hope it useful to all of you. He also offered me to come to Cincinatti for initial work-up and long distance treatment coordinated with a primary OB/GYN or medical doctor. So if any of you can travel it could be ideal if you keep hitting the brick wall! Best Of Luck to all you TTC or not - our health is our greatest asset and don't let someone convince you that you don't have a say in it! Denise/ NC
-- Red Roo
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