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Infertility Cubby

Regulation of Menstrual Cycles by Metformin
By Sam Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I haven't been officially diagnosed with PCOS, and I'm neither overweight or have excess hair or diabetes, but I've been prescribed metformin and it made me have a normal cycle for the first time in 16 months (I did not respond to Clomid). My question is: where the metformin is working for me, do you think it's possible that I have a mild case of PCOS?

A. The experts can't agree with what PCOS is. SO sure, you could have it. The largest single cause of lack of ovulation lies along the PCOS spectrum. It seems that about 50% of those with PCOS are insulin resistant and insulin resistance leads to lack of ovulation. Often insulin resistance will be missed on the routine lab testing for PCOS. I pay considerable attention to the ultrasound appearance of the ovaries. I bet there is an increase in small follicles (cysts) less than 10mm., or an increase in the size of the ovary. The fact that your cycles have regulated is great news. Hopefully a pregnancy is not far behind.

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