Metformin effects on ovulation (no pcos)

[clara_nb]

Hi all,

I posted this on a few different forums now so I am hoping someone has some words of advice. I started taking Metformin about a month ago. I have slightly elevated fasting blood sugar and my glucose tolerance is impaired. I am not prediabetic and I don't have diabetes but it runs in my family so I am taking precautions and my ob/gyn thinks Metformin may help. I am overweight and I may have insulin resistance. I don't think I have PCOS because I have been ovulating every month I have been TTC (confirmed with bloodwork on 3 different occasions). I normally have cycles between 31-35 days and I ovulate between CD 19-21. I am currently at CD 22 and I had started to show signs of ovulation (cervical mucus etc) earlier this week and I had a light line on an OPK. By CD 20 the line was totally gone and my mucus had dried up but I never got a positive OPK. I did go up to 1000 mgs of Metformin this week from 750 last week-- does anyone know if that might affect ovulation and if I go back down to 750 or 500 if I might still ovulate?

Any advice at all would be appreciated! It's now the weekend and my OB/Gyn's office is closed until Monday. I dont want to miss my fertile window.

Thanks!

 

[Palladium]

Hi, I'll try to help, hope its still useful.

Metformin should actually help you ovulate if anything, particularly if you have some problems with blood sugar, that's why it's often prescribed for TTC. If your blood sugar control is messed up that will interfere with ovulation, metformin helps correct the imbalance and will improve ovulation, so I don't think increasing your dose will have delayed it.

In my case I was diagnosed with insulin resistance after nearly 2 years of trying with absolutely no luck and was put on metformin (1000mg to start with) and saw an almost instant improvement in my cycles and was pregnant within 5 months of starting. I had been ovulating on my own before that but my follicles were always a bit small, and my LH, estrogen and progesterone levels were not great either. Once I started metformin I went from ovulating anywhere from CD18 to 25 to textbook CD13-14 with much better follicles and hormone levels. That said, metformin doesn't work for everyone, but its worth giving it a try for a few months.

OPKs are not always reliable, especially in cases of PCOS/insulin resistance. I never found them helpful, but luckily I can always feel it when I ovulate. If you don't have any other method of figuring out when you ovulate then you can keep using them, but personally I wouldn't bother with the hassle.

Sometimes you might just have an unusual cycle, the safest thing is to keep trying every couple of days until you are sure you've ovulated or AF comes.

Hope this is helpful!

 

[clara_nb]

Thanks, it is definitely still useful. I have never had the quality of my eggs tested so it is possible there may have been issues with them. If they were "bad eggs", do you think the Metformin would stop them from being released?

What is really getting me down about all of this is that I (to my knowledge) have never had an anovulatory cycle. Now that has changed and I am really stressing out. The fact that I ovulate has been the one thing that has kept me hopeful throughout my 1.5 years TTC. I haven't officially been diagnosed with Insulin Resistance -- I just had some impaired results on bloodwork where my sugars were higher than normal (but not high enough for real concern) and my OB/GYN suspected it. I have ovulated on different cycle days each month (it can be hard to predict, which is why I use the OPK's as I am working with a sperm donor) but my Luteal Phase has always been 11 days. On the days leading up to ovulation I always have EWCM and cervical position changes. This month I started to experience that and then it just disappeared, full stop. Today is CD26 and nothing so far. I don't think I've ever gotten this far into a cycle without ovulating. My OB/GYN wants to send me for bloodwork but I don't know what for. I'm getting very frustrated. I haven't actually been in to see her in 2 months -- she just keeps communicating through her admin staff. I know she is busy but it's hard not to feel like I'm alone in this.

Not having "easy access" to sperm makes this very difficult -- I can't just BD every other day all month because my donor isn't my partner and it takes a lot of coordinating of schedules to get his donations (his, mine, and my wife's). The other thing is the side effects of Metformin... even after a month, I am still having bad GI symptoms from it.

Thanks for reading my rant!

Hi, I'll try to help, hope its still useful.

Metformin should actually help you ovulate if anything, particularly if you have some problems with blood sugar, that's why it's often prescribed for TTC. If your blood sugar control is messed up that will interfere with ovulation, metformin helps correct the imbalance and will improve ovulation, so I don't think increasing your dose will have delayed it.

In my case I was diagnosed with insulin resistance after nearly 2 years of trying with absolutely no luck and was put on metformin (1000mg to start with) and saw an almost instant improvement in my cycles and was pregnant within 5 months of starting. I had been ovulating on my own before that but my follicles were always a bit small, and my LH, estrogen and progesterone levels were not great either. Once I started metformin I went from ovulating anywhere from CD18 to 25 to textbook CD13-14 with much better follicles and hormone levels. That said, metformin doesn't work for everyone, but its worth giving it a try for a few months.

OPKs are not always reliable, especially in cases of PCOS/insulin resistance. I never found them helpful, but luckily I can always feel it when I ovulate. If you don't have any other method of figuring out when you ovulate then you can keep using them, but personally I wouldn't bother with the hassle.

Sometimes you might just have an unusual cycle, the safest thing is to keep trying every couple of days until you are sure you've ovulated or AF comes.

Hope this is helpful!

 

[Palladium]

Wow, it does sound like things are tough for you. I was very lucky and never had any side effects from metformin, but I know they can suck.

I totally get just wanting to know what's happening, but often you just never get answers. I don't think metformin directly affects the quality of your eggs, just the other processes. In my case I got much better levels of estrogen, my lh surge was stronger and better timed, my follicle size was much better and my progesterone levels improved too. I started ovulating around day 14 instead of much later and my luteal phase increased from 11-12 days to 14.

Everyone does have the occasional annovulatory cycle, even people who are perfectly fertile, so I would guess this is just a coincidence. I know it must be frustrating since you're using a sperm donor, but I would definitely stick with the metformin for at least three or four months to give it a chance.

 

[May55]

Metformin wont effect the release of the eggs.. I have been taking it for almost a year now (1000mg/day)...my doctor and my endo explained that with PCOS it may help me ovulate on a more regular time but thats all it will do as far as ovulation. It made my cycles less long and as for ovulation im not sure how thats going, I seem to ovulate lol but im not testing anymore.
I just want to add, the only symptom I have from my PCOS is insulin resistance and long cycles.. I never thought I would have it..

 

[SandraM]

Metformin actually induces the ovulation. Metformin has a more substantial benefit for fertility when the woman has been taking it for at least 60 to 90 days. Increased dose of metformin may not impact on your ovulation. If you haven’t suffered any side effects of Metformin then you can tolerate 1000 mg dose. And if you can tolerate the 1000 mg dose, then reduce the dose to 750mg or you can further reduce to 500mg. But do not take this decision by your own, consult your doctor before any alteration of dose.