Metformin, PCOS, and Fertility

Metformin, PCOS, and Fertility

 If you have heard of PCOS or are wondering what fertility drugs you might be prescribed when seeking fertility help, metformin may have popped up in your search results. But knowing what it is used for and how it may affect your fertility treatment can be hard to pinpoint. 

Here we’ll break down how people use metformin to get pregnant, how metformin is used to treat PCOS, and what you need to know about metformin and your fertility options. 

What is Metformin?  What is PCOS?

Metformin is an insulin-sensitizing drug used primarily to treat type 2 diabetes. It lowers blood sugar levels in diabetes patients by reducing insulin resistance

In infertility practices, metformin is most commonly used in patients who have PCOS, or Polycystic Ovary Syndrome.  PCOS is a common hormonal disorder that results in too much male hormone (androgen) levels which prevent women from ovulating regularly and often results in infertility.  PCOS patients often have insulin resistance, in which the cells in the body become less reactive to normal levels of insulin, thus making them less sensitive to insulin levels.  This causes the body to think there is not enough insulin present which then causes the body to try and compensate by making even more insulin. 

Studies have shown a connection between insulin and reproductive hormones, finding an increase in insulin levels leading to an increase in androgens. Because metformin lowers levels of insulin, it has been found to be effective in controlling the effects of PCOS.  Metformin has been shown to help PCOS patients establish regular menstrual cycles and restart ovulation.  Some studies have even found that it may decrease miscarriage rates and decrease gestational diabetes in PCOS women. 

There are other benefits of taking metformin over other medications. It does not cause weight gain or fluid retention which can be a major issue for many medications. It also does not cause hypoglycemia, lipid alteration, or increased insulin secretion.

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Metformin and Clomid

When working with your fertility doctor to create your infertility treatment plan, clomid is often the first choice for PCOS patients who are trying to get pregnant. Clomid can help force or restart ovulation, but for those who have diabetes, insulin resistance, or an impaired glucose intolerance, metformin may be preferred instead.  Because it has been shown to regulate menstrual cycles, reproductive hormones, and help ovulation return to PCOS patients, doctors may prescribe it without other fertility drugs in hopes that it will be effective on it’s own. Metformin and ovulation return can be promising but it also has varied effects and does not always work. 

Your fertility specialist might also prescribe clomid and metformin together; metformin has been found to be effective for improving success rates of ovulation induction for women who are taking clomid.  Studies have also suggested that this may increase fertility success results for Clomid resistant patients.

Metformin Side Effects

The most common side effects of metformin include diarrhea, nausea, vomiting, and flatulence.  These symptoms will usually subside over time and taking it with meals may help reduce these effects. Also, to help minimize these side effects,the fertility doctor will often have patients start at a low dose and build up slowly allowing time for the body to acclimate. 

 Because metformin is broken down by the liver and cleared by kidney, it is usually not given to patients who have liver disease/dysfunction, have severe illness, have renal compromise, consume excessive amounts of alcohol, or have a risk for lactic acidosis. 

At Reproductive Health and Wellness Center, we are dedicated to constantly working with the latest research and catering to your specific fertility and health needs in order to provide you with the highest quality of care. We focus on education, personal guidance, and whole body health and wellness while also bringing in cutting edge fertility treatments to try and help you build the family you’ve been working for. Our founder, Dr. Marcus Rosencrantz, is an expert in fertility care, and is always willing to answer any questions a patient may have. To book a consultation, you can click here, or, we can always be reached by phone at (949) 516-0606 . 

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