Disobeying doctor's directions for discontinuing Metformin — The Bump
Pregnant after IF

Disobeying doctor's directions for discontinuing Metformin

I was diagnosed with PCOS by my original Ob/Gyn in 2011 when we first started realized we were having trouble TTC. She diagnosed me based on CD 3 b/w that showed elevated testosterone and an elevated fasting blood glucose level. I was prescribed 1500mg daily Metformin which has since made my A1C and levels manageable ever since. When I visited an RE, the RE decided I did not have PCOS but kept me on it because she said it was good for my blood sugar levels and "wouldn't hurt anything"

I have also been under the care of a primary care doctor who agrees I should be on it PCOS or not, and in fact I switched Ob/Gyns in 2012 and she also said I would want to continue on it during pregnancy, if and when that happened. She said discontinuing Metformin during pregnancy could be harmful because it can cause miscarriage due to blood sugar fluctuations. Besides,it's a class B drug with no proven negative implications to a fetus. None. In 2012, I did a ton of research myself and found many reputable  studies that confirmed that there has never been proof that there is harm to the fetus during pregnancy. 

Fast forward to now. I have a new RE, and of course when I started with him I listed all of my current meds including Metformin during their intake process. It has never been brought up since so I assumed it was okay to continue taking it.

However yesterday, when my nurse emailed me telling me we were adding synthroid to the mix, I asked if there would be any interactions with it and Metformin. My nurse seemed surprised that I was taking metformin at all (despite the fact that I listed it at intake and should be on my file.) Well, today I get an email saying that my RE wants me to discontinue use immediately now that I'm pregnant.

Again, everything I have read and even heard from my new OB/gyn says it's safe, and can actually be quite harmful to stop. It has been proven to help decrease miscarriages, gestational diabetes in late pregnancy, and can even help with milk production. 

I emailed the nurse back saying I was reluctant to stop for these reasons and asked for supporting evidence to discontinue, but I'm afraid they will put their foot down. I just have a really bad feeling about stopping it. I hate the idea of going against a doctor's direction which is something I've never done before. But technically, my OB has a conflicting opinion and says it's safe! Would you continue to take it even if your RE said to stop? Would you tell your RE you're disobeying (and probably irritate the hell out of them) or just keep taking it without their knowledge?

Thanks for reading all of this! 

************ Signature/Ticker Warning ************
Me (32) DH (36) - Finding our way to baby #1
Me: POF/DOR - AMH <0.16, heterozygous c677t MTHFR, insulin resistant and gluten intolerant
DH: Severe MFI

12/2/11 - IUI #1- BFN 
8/1/12 - IVF #1 - Zero response from max stims (600iu intramuscularly)
My ovaries are just for decoration

12/6/12 - Adopted five embryos that had been frozen for over ten years!
2/11/13 - DEmbryo FET #1 Thawed four, sadly two didn't survive. Transferred two beautiful blasts. 
2/16/13 - First BFP of my life @ 6dp5dt! EDD 10/30/13
3/27/13 - After beta and u/s hell, no heartbeat ever detected. D&C at 9w1d.

6/5/13 - Adopted four new embryos that had been frozen for seven years!
 
9/12/13 - DEmbryo FET #2. Thawed and transferred two beautiful blasts
9/17/13 - BFP @ 5dp6dt! EDD 05/31/14
9/29/13 - m/c @ 5w1d. :(

11/19/13 - DEmbryo FET #3. Thawed and transferred one blast from each batch. Wow!
11/23/13 - BFP @ 4dp6dt! EDD 8/7/13
Beta #1 @ 13dp6dt - 522  Beta #2 @ 16dp6dt - 1373 
6w5d ultrasound showed one perfect baby with a beautiful heartbeat of 134bpm!

Snowflake baby is a girl! 
Our beautiful Snowflake girl arrived on July 22, 2014! 
 
 
My embryo adoption blog: Wishing on a Snowflake
 
    image      image 

Re: Disobeying doctor's directions for discontinuing Metformin

  • Keep taking it. Your re is not a diabetes specialist or an OB and should not be taking you off medicine if the OB and PCP both think you should be on it. I would tell them you are continuing because your PCP and on say so and if he had a problem have him call them.
    6 m/c
    Anovulatory cycles, increased Synthroid Diagnosed Sep 2010
    Natural cycle Dec 2010 BFP M/C 6 1/2 Weeks, D&E Jan 2011
    1 Clomid/Ovidrel BFN May 2011
    Natural cycle Aug 2011 BFP M/C 4 Weeks
    1 IUI Sept 2011 BFP M/c 7 weeks
    Provera Dec 2011 BFP M/C 3 Weeks
    DQ ALPHA HLA MATCH, High NK Cells Diagnosed Dec 2011
    IVF March 2012 BFP m/c 4weeks 5 days (IL, Prednisone)
    IVF#2w/DS July 2012 MEGA FAILURE BFN (IL, Dexamethasone)
    Diagnosed No real HLA Match, DQ Beta Triad, High TNF, Low NK Cells
    Oct 2012 Natural Cycle m/c 4wks (Lovenox, Prednisone) 
    Went to Beer Center- high tnf, low lad, implantation failure
    Nov/Dec 2012 LIT Treatment
    Dec 12 Humira
    Jan 2013 BFP
    Humira,LIT,Prednisone, Lovenox, IVIG, Baby Aspirin
    Miracle Born August 2013 Premature

    Yours doesn't have to be a sad story



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    Lilypie - (ugiy)


  • My OB asked me to stop taking it as well around 8 weeks. I took it until 1st tri was over because it is what made me feel most comfortable. FWIW, I was was/am on Synthroid as well & had no issues. I take Synthroid in the AM & took my Met in the evening.


    04/07/11- PCOS Diagnosis w/GYN. Put on Metformin (1500 mgs)
    04/25/11- 1st consultation with RE (Confirmed PCOS & Anovulation)
    05/09/11-HSG-All clear! 05/13/11-SA-Normal. Found out on 2/14/12, low Morph (1%).
    06/17/11-10 days of Clomid (100, 150) No response.
    07/10/11-03/20/12- 5 Injectable (Follistim) IUI cycles; 4 BFN, 1 C/P. (stims ranged from 11 days to 25 days)
    05/28/12-Diagnosed with Hypothyroidism. 75 mcg Synthroid.

    IVF with ICSI in June/July 2013 = BFP!. Beta # 1 = 123. Beta # 2 = 252. Due March 25th. Baby boy arrived March 27, 2013!

    FET #1 - 10/4/14 = BFP!! Beta #1 = 179. Beta # 2 = 499. Due June 22nd.

    Daisypath Anniversary tickers
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  •     
  • talk to the RE in person (or at least by phone), not the nurse via email.  Not all dr's agree on one thing, so 2nd opinions are invaluable.  I , personally, have known many people that stay on this through the first trimester-- i would trust my OB more with this or at least want to know EXACTLY why the RE is saying no-- then bring this to info to my OB before doing anything!

    You shouldn't ever blindly follow what a Dr says-- you have to be your own advocate, and sometimes follow your own instincts. and always, always get 2nd opinions! 


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  •     
  • Keep taking it!  Check with the OB on the synthroid instead.  No doctor can put his or her foot down in this situation.  You always have the option of walking out of that RE clinic and seeking care elsewhere.  Based on your research sounds like a MUCH bigger risk to stop.
    TTC #1 Since 4/2010, Cycle 30
    Positive for HLA-B27, I'm a mutant :p
    Testing - Me ok, gluten issue? DH - borderline count, low motility
    4/28/11 IUI#1 = BFP!(5/25), EDD 2/2/12 - m/c 5w3d
    7/3, 7/31, 9/25 - IUI#2-4=BFN
    IVF#1 - 1 blast = BFP!! (12/30), EDD 9/9/12, confirmed c/p 4w2d
    FET#1 3/2/12 - 2 blasts =BFP!! EDD 11/18/12, us#1 = twins! Confirmed m/c 5w6d
    4/20-surprise BFP and another c/p 4w2d
    FET#2 7/16/12 - 2 blasts = BFN
    FET#3 8/20/12 - 1 blast - BFP!! Beta #1-2=177, 354
    1st u/s 5w6d, one beautiful little HB :), 2nd u/s 146bpm
    baby girl born 5/10/13

    TTC#2 since 12/17/2014, Cycle 8
    Repeat Testing...FSH=12, AMH=3.8, AFC=28. 
    IUI#5 5/10/15- c/p?
    IVF#2 8/19/15 - cancelled due to cysts
    IVF#2 take two 10/2015 - 5 blasts frozen
    FET#4 12/11/2015 - BFN - 4 blasts remaining
    FET#5 2/18/16 - BFP!!!  Beta1-3, 126, 250, 745!!

    Image and video hosting by TinyPicLilypie Angel and Memorial tickers

    Tons of love and ((hugs)) to my IF sister NMscubagirl


  • I would definitely talk to your RE and tell him you are getting conflicting information between him and your OB. I would ask him to consult my OB so that they could come to a consensus together (maybe call your OB and let them know what's going on). That is very frustrating when doctors have different opinions, and you just want to do what's best for your LO! Good luck!
    Me: 30, DH: 30
    ~*~Married 8/31/08~*~

    DX: MFI due to Chemo/Stem Cell Transplant for Hodgkin’s Lymphoma. RE said IVF is best option with DH's frozen boys.
    IVF #1 April 2012: Menopur and Bravelle; 1 egg retrieved, 0 fertilized. Boo.
    IVF #2 August 2012: Gonal-F 300, Menopur 300. Beta #1 9/6: 382... BFPx2!

    Image and video hosting by TinyPic

    Our boys couldn't wait to meet us! Colin and Kieran arrived March 26, 2013 at 33w1d.

    Image and video hosting by TinyPic
  •     
  • I would ask the drs to call each other and figure this out.  My dr put me on it because even though my blood sugar and glucose testing was all good he want4ed to make sure that it stayed ok throughout the pregnancy.  I am still on it.  So I do not understand why they would take you off of it.

    Married 12-12-04
    TTC since 07
    me-36 PCOS, Tubal Problems, and polyps removed 7-12
    DH - 36 extremely handsome and no fertility problems
    IUI 8-12 and 9-12 failed
    IVF 12-21-2012 - 2 I think perfect no matter what the dr graded them (2B)embryos transferred Beta on 12-31-12 Positve - Beta is 21
    Beta 2 1-2-13 - 31
    Beta 3 1-4-13 - 53
    Beta 4 1/9 - 212!
    Ultrasound 1/10 - Nothing completely empty uterus Beta 1/14 - 743; Beta 1/17 - 1704 ultrasound shows nothing. Officially a miscarriage. 1/21 Beta 3900 Dr. says it ectopic. Ultrasound shows a miracle heartbeat right in the uterus where it belongs! Dr. says I can be cautiously optomistic!!! Hang in there baby!
    [IMG]http://i50.tinypic.com/2pye4xi.jpg[/IMG
    ]
  • Thanks for the advice, ladies. I haven't heard back from the RE's nurse yet, but just to be sure I called my OB and asked the question again. He said he will keep me on metformin and if the RE has any questions, they can call him directly. I'll let them hash it out but I'm not going to stop taking it. It just doesn't sit right with me.

    ************ Signature/Ticker Warning ************
    Me (32) DH (36) - Finding our way to baby #1
    Me: POF/DOR - AMH <0.16, heterozygous c677t MTHFR, insulin resistant and gluten intolerant
    DH: Severe MFI

    12/2/11 - IUI #1- BFN 
    8/1/12 - IVF #1 - Zero response from max stims (600iu intramuscularly)
    My ovaries are just for decoration

    12/6/12 - Adopted five embryos that had been frozen for over ten years!
    2/11/13 - DEmbryo FET #1 Thawed four, sadly two didn't survive. Transferred two beautiful blasts. 
    2/16/13 - First BFP of my life @ 6dp5dt! EDD 10/30/13
    3/27/13 - After beta and u/s hell, no heartbeat ever detected. D&C at 9w1d.

    6/5/13 - Adopted four new embryos that had been frozen for seven years!
     
    9/12/13 - DEmbryo FET #2. Thawed and transferred two beautiful blasts
    9/17/13 - BFP @ 5dp6dt! EDD 05/31/14
    9/29/13 - m/c @ 5w1d. :(

    11/19/13 - DEmbryo FET #3. Thawed and transferred one blast from each batch. Wow!
    11/23/13 - BFP @ 4dp6dt! EDD 8/7/13
    Beta #1 @ 13dp6dt - 522  Beta #2 @ 16dp6dt - 1373 
    6w5d ultrasound showed one perfect baby with a beautiful heartbeat of 134bpm!

    Snowflake baby is a girl! 
    Our beautiful Snowflake girl arrived on July 22, 2014! 
     
     
    My embryo adoption blog: Wishing on a Snowflake
     
        image      image 
  •     
  • I had the opposite problem. I was put on it by RE after an early miscarriage after my 3rd IUI. I do have PCOS and are pretty much textbook. I had tried it in the past but always had stomach issues on it. So RE convinced me to try it again after my mc and I took it while gearing up for IVF, but only 1000mg. Our first IVF was successful and RE told me to stay on it until 12-14 weeks. OB actually wanted to keep me on it for the reasons you stated. She didn't understand why RE wanted to take me off. Anyway, I made the decision to taper down and went fully off at 14. I know I'm at risk for GD, but I didn't want to be on metformin for life and would prefer to regulate my blood sugar through healthy diet and exercise. So I want to see how I do this pregnancy and fingers crossed I can get through it without GD! 

    Id say stay on it and you've done the right thing so far, ask for supporting evidence on why they want you to go off it. Personally, I wouldn't go off during first tri but thats me. Everyone is different.  

    Pregnancy Ticker
  • Some doctors will keep you on it throughout your entire pregnancy. Some take you off early, some after 1st Tri. It really just depends on the doctor and patient. Like you said, there's no research to suggest it will harm your baby so if you're more comfortable taking it, as is your OB's recommendation, I'd continue.

    I was given the ok to start tapering down my 2000mg/day dose by my RE at week 9 and to be completely off it by week 10-11. I chose to continue taking it until week 12, when I was also given the green light to stop the progesterone supps. At my recent OB appointment (13w), my OB specifically verified that I had stopped the Met and P4 supps so I guess had my RE not already stopped me, she was going to.

    I'm also on synthroid and was diagnosed with PCOS by my OB which is why I started the Met in the first place.

    **PAIF/SAIF Welcome**
    TTC #1 March 2010 - Nov 2012
    Me: 29, PCOS (anov), Hashimoto's Disease // DH: 30, normal SA
    3 Clomid, 1 Clomid/Menopur, 1 Menopur w/ TI (CX 4x's due to cysts) - All BFN
    1 Clomid/Menopur, 2 Menopur, 1 Follistim w/ IUI - All BFN
    RPL & Karyotype testing normal


    IUI #5 (12/1/12) --> Follistim + 1/3 hCG Trigger = BFP! EDD: 8/23/13
    Betas --> 61 (13dpo) // 156 (16 dpo) // 223 (18dpo) // 656 (21 dpo)
    U/S --> 5w0d - sac seen // 6w0d - hb detected // 7w0d - hb seen and heard, measuring 6w6d!
    8w6d - wiggly baby! // 9w3d - wiggly baby with fingers!

    Baby boy born 8/24/13

    imageimageimage 

      My Blog: Searching for Lucky Socks

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