Pregnant with PCOS and Insulin Resistance

musicmama10

Hi everyone

 Looking for some advice!  I'm new to The Bump, so please bare with me!

 I just found out 2 days ago I am pregnant.  Not sure how far along I am yet since I don't have regular cycles due to PCOS (we're thinking about 4ish weeks but my HCG levels are REALLY high and I am REALLY sick, so not too sure).  I also got pregnant last summer but had a miscarriage around 12 weeks (best estimate based on ultrasounds).

 I also have Insulin Resistance and take Glumetza (slow-release Metformin) and PIoglitazone (insulin sensitizing med).  In the summer I was taken off ALL meds, including the metformin,  Have heard I shouldn't have come off that since staying on it would have decreased the chances of miscarriage.

 Just wondering what other people's experience has been with PCOS and IR in pregnancy.  What did you do with your meds?  Any other things you were told to do?

 I have no specialists (other than my OB/GYN) near me to get more info on IR in pregnancy and it's a little overwhelming on the internet!!!

 Thanks a lot! 

aschleser

Congratulations!  I have PCOS and IR.  I had been on metformin since I was 15 (almost 8 years when I got PG).  My dose hadn't been changed in YEARS, and my new endocrinologist upped it about 2 months before I got pregnant, YAY!).  Anyways - I took the Metformin through week 12 (1st trimester) of my pregnancy, and then stopped it.  My OB suggested to stop it sooner, but the endo said it will help prevent miscarriage, so I listened to the endo, as far as I know, its not harmful to the fetus, and some women stay on it the whole pregnancy for GD.  As for IR - I wasn't on the other medication, so I don't have input on that. 

The only thing "special" re: PCOS this pregnancy (besides the metformin thing) was 2 glucose tolerance tests.  Most women just get 1 test at ~26 weeks, I had one at 16 weeks and passed with flying colors (my level was 75), my next one is in 2 weeks.

Do you see an endocrinologist? I didn't get in to see mine yet this pregnancy, but was able to talk to the actual MD on the phone about my metformin, and she helped answer a lot of questions.

musicmama10

Thanks so much.  I don't have an Endocrinologist.  The closest to me is over 4 hours away.  My OB has told me to stay on the metformin, but I don't know for how long.  Some things I have read/been told say 12 weeks, some say 14 weeks, and some say 20.  Am a little nervous since we believe I miscarried last time at 12 weeks.

Last time I wasn't able to do glucose tolerance testing -- they sent me when they thought I was about 9 or so weeks.  My glucose was too high to drink the orange stuff to even do the test.  Normally my blood sugars are on the low side of normal.

 Think I'll be referred to the Diabetes Education Centre in my community as an urgent patient next week.  Just a little nervous with my experience from the summer! 

aschleser

For the glucose tolerance test - mine wasn't a fasting glucose level, when I passed - I ate 2 eggs cooked over medium with black pepper on them, and pam in the skillet to keep them from sticking.  No butter, toast, or anythign else.  I don't remember if I had a glass of milk (1%), but I'm sure I had a small one.  I had my GTT about 3 hours later, and passed.  I tried to avoid sugary foods for a while before hand, and honestly have REALLY watched my sugar intake the whole pregnancy, as I am scared to death of GD!! 

CMM05

Hi-

Congrats on your BFP! 

I also have PCOS, but have not been found to be IR. However, I have been on Met for all of my PG's (I have been PG 6 times......3 m/c's, 2 healthy boys and baby #3 on the way).

I would highly recommend staying on Met until the beginning of 2nd tri (15 weeks or so....).

I have not taken any other meds relating to PCOS/IR, so I can't help you there.

My OB's are not that versed on PCOS. I just kept myself on the Met all times until the 2nd tri. They never said anything and we didn't really discuss it There is no harm in taking it, only benefits.

GL!

 

jojobean1977

I have PCOS and take Metformin 1000mg twice a day and will continue throughout my pregnancy and while breastfeeding. I see a reproductive endocrinologist yearly while not pregnant and did to help me get pregnant and up until 12 weeks pregnant then I was released to my high risk ob. Metforin has been shown in studies to decrease the miscarriage rate in women with PCOS. Many REs also give women with PCOS progesterone to help prevent miscarriages too since some women have them from low progesterone. Congrats and Good Luck to you!

lemen99

I was diagnosed with PCOS and IR approx 10 years ago or so.   I tried Met in college and it made me sick, so I just didn't take it and instead used Provera to induce periods.

 To get pregnant, I didn't have a cycle, so I went on Met and a low sugar diet.  I was on 500 mg for a while and I still didn't have a cycle, but 3 months after going up to 1000 mg, I ovulated and got pregnant. 

When I got pregnant I had 2 blood draws for progesterone and beta.  Mine were on the low side so I was put on prometrium supplements in 1st tri to prevent miscarriage.

They doctors kept me on Met during my pregnancy. My doctor told me to keep taking it.  I ended up going to another hospital due to IC and premature birth (unrelated) and they were surprised at 24 weeks I was still taking it.  I don't know why my doctor kept having me take it, but I think most doctors have you stop taking it.  I never got to 28 weeks so I never took the GTT.

After the birth of my son my body changed.  When I stopped pumping, I  had perfect, regular 30 day cycle.  I didn't take Met after his birth.  I guess my hormones changes.  I got pregnant on my 2nd cycle.

I got a blood draw again with this pregnancy and since it was barely in the normal progesterone range, they put me on Prometrium again to prevent miscarriage, just in case. 

 

hispenguin

Congratulations on your pregnancy!

I have PCOS, with borderline IR. I don't get a period on my own, so we were doing fertility treatments to get pregnant. As a result I was kept on Met (the same type you were on) for my entire first trimester to try to reduce the risk of miscarriage. I was also on Progesterone suppositories for the same reason.

Because of the PCOS and IR, I was sent for a Glucose Tolerance Test earlier on in the pregnancy at 18wks, and was diagnosed with GD at 19wks. I was immediately sent for education regarding diet, but could not control all of my numbers with diet alone and have been on Insulin before bedtime since 21wks.

I would definitely recommend at the very least being tested earlier on for GD, with another test done at the usual time if you pass the first one. You can never be too careful since with PCOS you're at a 40% higher risk of getting it.

Other than those things I have been treated no differently than any other pregnant woman by my midwife then my OB once I went on Insulin.

KarlsSweetie05

I have PCOS with IR too.

Take 2000mg extended release metformin daily even today at 26+ weeks.

I have a regular endocrinologist that I normally see 4x a year also.  Dr. kept me on same dosage this pg.

Took 1 hour and 3 hour GTT earlier than most based upon history and also due to twin situation.  Failed both tests. 

Attended special GD class at hospital and it was great info / training.  I've been able to control #'s so far via diet and 2000 mg of metformin daily.

I also was on progesterone supplements through 17 weeks also.  My progeserone levels were also low and believed to contribute to prior m/c.

Wishing you a H&H 9 months!

musicmama10

When are the progesterone levels tested usually?  Assuming it's done through blood work.

 Mine were never tested in my first pregnancy. 

mcwhittaker

I didn't know I had PCOS, I just knew i had some form of "infertility disease".

I was put on Metformin for insulin resistance (diagnosed borderline diabetic) and was surprised to find out about 6 months later that i was 7.5 weeks pregnant.

I was taken off the Metformin around that time, but only because my sugars had leveled out and it was actually causing me to have hypoglycemic episodes daily.

I also read that staying on the Metformin during first trimester can reduce chance of miscarriage.

Your doctor should be able to help you make the best choice for your particular circumstance. Obviously if you end up like me, hypoglycemia is not a good place to be and they will take you off the meds  

jgiles

I have PCOS and IR. Have been on 1500 of metformin for over 2 years. I also have had a low progesterone. My fertility specialist/endocrinologist sent be to the High risk OB and I get to get off the metformin at 14 weeks. I'm also now weaning myself off the progesterone and should be off between 14 and 15 weeks.

musicmama10

Thanks all!  Have made it to just over 15 weeks now and am still on my Metformin.  Just saw my OB/GYN yesterday and she didn't seem too sure of how long I should stay on it.  I know some of you have posted 14 weeks to whole pregnancy.  Just wondering if there is a "standard"?