Tamoxifen and Metformin

[AMP26]

Hello ladies I'm starting cycle number 40 (seems so crazy to me that that number has crept so high!) but this cycle I am on meds for the first time! My doctor has me on 750mg ER Metformin once a day and 10mg Tamoxifen twice a day. Does anyone have experience (good or bad) with either of these? I noticed that Tamoxifen does not seem to be given out to often... my doctor is a huge fan of it though!

 

[lisap2008]

Metformin decreases the level of androgens produced by the ovaries and adrenal glands. It also helps the body lower blood sugar and increases the effectiveness of ovulation drugs when they are taken together.

Tamoxifen is a breast cancer drug that was found to induce ovulation much like Clomid,the great thing about it is the side effects are much less then with clomid on tamoxifen I only had headaches and some insomnia and it does not thin the uterine lining or dry up CM like clomid can. I actually had more EWCM on it. I did not do much for me but I ovulate fine on my own. Good luck!.

Clomiphene citrate versus tamoxifen for ovulation induction in women with PCOS
Abstract
Objective
To reevaluate the efficacy of induction of ovulation with CC versus TMX in a group of anovulatory subfertile women with PCOS in a randomized controlled trial.

Study design
A prospective randomized controlled study in which 371 PCOS patients were randomly allocated into two treatment groups: group A (187 patients) where women received CC and group B (184 patients) where they received Tamoxifen for one treatment cycle. The outcome measures were number of growing and mature follicles, serum E2 (pg/ml), serum progesterone (ng/ml) and endometrial thickness, the occurrence of pregnancy and miscarriage.

Results
The number of stimulated follicles reaching &#8805;16mm diameter was significantly more in the CC group compared to Tamoxifen stimulated group (2.1 SD±0.1 vs. 1.1 SD±0.7, p<0.0001). The endometrium at the time of hCG administration was significantly thicker in the TMX group (10.1±0.1mm vs. 9.3±0.4mm, p<0.0001). Ovulation occurred in 120/187 cycles (64%) in the CC group and 95/184 cycles (51.6%) in the TMX group with a significant difference between two groups in favors of clomiphene (p=0.01). Serum E2, on the day of hCG administration, was significantly higher in the clomiphene group (p<0.0001). Pregnancy occurred in 35/187 cycles in group A (18.7%) and 20/184 cycles (10.8%) in group B and the difference was statistically significant (p=0.04).

Conclusions
Clomiphene citrate is more successful than tamoxifen as a first line therapy for ovulation induction in women with PCOS.

 

[AMP26]

Thanks for the additional information. From what you posted, it seems people do better with the clomid. I think I'll give the Tamoxifen a few cycles then request to be put on the Clomid if nothing changes! I guess I'll have to wait and see if this gets me to actually ovulate this month!!!

 

[lisap2008]

We had a tamoxifen thread last summer on the TTC over 35 board and one of the girls on 20mg got a BFP her first cycle so it does work for some. good luck!.

 

[AMP26]

Well, that's good news!!! THANK you and good luck to you too!!!

 

[honeycheeks]

I have done 2 ccyles of tamoxifen 20mg and metformin 1500 mg a day. i usually ovulate on clomid on 150mg, maybe thats why I was prescribed 20mg of tamoxifen. I ovulated fine on the first cycle. but in the second one, I hardly had any leading follicle.I dint have any unpleasant side effects that I remember. I am not really sure how well it works for others. Good luck

 

[chan1983]

Hi AMP26 how are things going. I was on clomid and fell pregnant on the 2nd mth of trying but sadly miscarried. I then went back onto clomid for another 4 mths and had no further joy with it. My doctor then talked to me about Tamoxifen which is a newer drug than clomid but it is a lot stronger than clomid. I've been on Tamoxifen since the middle of last year on and off and had an miscarriage and a chemical pregnancy. I am now offically waiting to see if i am currently pregnant as the witch hasn't showed her face and i'm at least 2 days late and have quite a few promising signs but had 2 BFN's so gonna be testing again very shortly.
I am on 40mg of tamoxifen. I hope all goes well for you xx

 

[AMP26]

Hi AMP26 how are things going. I was on clomid and fell pregnant on the 2nd mth of trying but sadly miscarried. I then went back onto clomid for another 4 mths and had no further joy with it. My doctor then talked to me about Tamoxifen which is a newer drug than clomid but it is a lot stronger than clomid. I've been on Tamoxifen since the middle of last year on and off and had an miscarriage and a chemical pregnancy. I am now offically waiting to see if i am currently pregnant as the witch hasn't showed her face and i'm at least 2 days late and have quite a few promising signs but had 2 BFN's so gonna be testing again very shortly.
I am on 40mg of tamoxifen. I hope all goes well for you xx

Any luck Chan? I'm getting my Beta done tonight, but I've had 5 negative HPT's so, I'm not holding out too much hope! I'm actually going to ask my REto up my dosage on Tamoxifen. How much do you take? He had me start on 20 mg...even at that dosage I got bad migraines from it, but I only had one follicle and it was on the small side. I'm hoping if we up the dosage I can get at least two and maybe they'll be a bit larger.

I'm hoping this is your cycle and that you get your BFP If not, looks like I'll still be around next cycle (#41 for me...)

 

[Lily7]

Management of anovulatory infertility associated with polycystic ovary syndrome: tamoxifen citrate an effective alternative compound to clomiphene citrate.
Nardo LG.
SourceDepartment of Obstetrics and Gynaecology, Frimley Park Hospital, Camberley [corrected] UK. [email protected]

Erratum in
Gynecol Endocrinol. 2005 Jul;21(1):63.
Abstract
Clomiphene citrate (CC) is widely used as first-line treatment for ovulation induction in anovulatory women with polycystic ovary syndrome (PCOS). Tamoxifen citrate (TMX), another non-steroidal selective estrogen receptor modulator, may also be effective on the resumption of ovulation in these women. The aim of this controlled observational study was to compare the efficacy and safety of ovulation induction with TMX versus CC in anovulatory infertile women with PCOS. A total of 102 consecutive women (mean age+/-SD: 31+/-3.6 years; range: 26-38) with PCOS were studied. Following a spontaneous or progesterone-induced withdrawal bleed, women received either 50 mg daily of CC (days 2-6) or 20 mg daily of TMX (days 2-5). In case ovulation failed to occur, the dose was sequentially increased to 100 mg daily of CC and 40 mg daily of TMX, respectively. Serum progesterone levels were measured on cycle day 21 to monitor the ovulation pattern. The overall ovulation rate was significantly higher in women who received TMX compared with those who received CC (61/98, 62.2% vs. 60/127, 47.2%, p=0.03). Although not statistically significant, the pregnancy rate per ovulatory cycle was higher in the TMX group compared to the CC group (14/61, 22.9% vs. 11/60, 18.3%, respectively). All pregnancies were single and there were no side-effects in either group of treatment. Collectively, these data demonstrate that TMX is a safe and effective agent, and a suitable alternative to CC for anovulatory infertility in women with PCOS.

https://www.ncbi.nlm.nih.gov/pubmed/15726910

Hi I am also on tamox, I found this online, hope it helps.

I am on my 4th round, I take 40mg days 2-5, my doc wont give me metformin I didnt respond to clomid, my fs says that some people who dont respond to clomid can respond perfectly to tamox and vice versa, good luck x

 

[AMP26]

I'm on my second cycle with Tamoxifen and Metformin. Last month we got cancelled because of a cyst... but I'm going to be honest, it was nice to have a break! We decided to try again this month with back to back IUI's, so hopefully that will do the trick. If not, we are thinking about taking the summer off to regroup emotionally. Even though this will only be our second medicated cycle, it is our 42nd cycle overall. I guess we will take this one thing at a time and see how this cycle goes

 

[MsTTC]

Hi everyone..
This is Ally and I have been trying to TTC over a year now...
My bloodwork and ultra sound show that everything is normal, except for my AMH which is a little low at 1.61
But the problem is I dont ovulate on my own for the last few months... I have a history of an EP in 2010... and I waited long enough to heal.
Clomid only produced empty follicles for me... and the doctor has made me switch to tamoxifen after 4 clomid cycles...

I notice that you all were using tamoxifen last year, so I wanted to ask if you had any success and how were the side effects?

 

[AMP26]

Hi everyone..
This is Ally and I have been trying to TTC over a year now...
My bloodwork and ultra sound show that everything is normal, except for my AMH which is a little low at 1.61
But the problem is I dont ovulate on my own for the last few months... I have a history of an EP in 2010... and I waited long enough to heal.
Clomid only produced empty follicles for me... and the doctor has made me switch to tamoxifen after 4 clomid cycles...

I notice that you all were using tamoxifen last year, so I wanted to ask if you had any success and how were the side effects?

Hi! I wanted to respond even though I don't have a success story! I tried Tamoxifen for three cycles but never got pregnant. We got pregnant from our first cycle with injectables though : ) That pregnancy ended with an ectopic but we are currently gearing up to try again! This time we will skip right to IVF though! Good luck to you!