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Infertility Cubby

Metformin and When to Start Other Fertility Therapy
By Sam Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I am 26 and have recently been diagnosed with PCOS. I have a 16 month old daughter that was conceived with fertinex. I have been having regular though light periods since April, but have not ovulated. I am taking 1500mg of glucophage a day. How many cycles should I wait before adding fertility treatment to the mix? My doctor is in a hurry, but I would like to get my system in order first and see if I ovulate on my own.

A. I usually will try clomiphene challenge in the 5th or 6th month of metformin. Some individuals who have been previously clomiphene resistant will ovulate and become pregnant on the metformin-clomiphene regimen, when neither alone is sufficient.

It is usually the patient and not the physician that is in a hurry. If you are making positive lifestyle alterations and are feeling better, plus starting to have regular cycles, what's the rush? At 26 and with one successful pregnancy, your chances for another pregnancy are very high. The drug companies will make sure that there is plenty of gonadotropins whenever you might need them.

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