metformin vs. clomid

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    metformin vs. clomid

    hi everyone.  i know this is not a new topic, but - has anyone out there had to choose between metformin and clomid, and if so, how and what did you decide?  what did you find were the pros/cons of each?  i think i'm about to start metformin (figured i'd try that before clomid) but it hasn't been an easy decision and i wonder what to expect.  i have what i call "mild" pcos (no abnormal male hormones, not overweight, not too hairy (!), no insulin irregularities, just a very irregular cycle and what look to be cysts on one ovary).  thanks for any feedback!
     
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    Re: metformin vs. clomid

    In Response to metformin vs. clomid:
    [QUOTE]hi everyone.  i know this is not a new topic, but - has anyone out there had to choose between metformin and clomid, and if so, how and what did you decide?  what did you find were the pros/cons of each?  i think i'm about to start metformin (figured i'd try that before clomid) but it hasn't been an easy decision and i wonder what to expect.  i have what i call "mild" pcos (no abnormal male hormones, not overweight, not too hairy (!), no insulin irregularities, just a very irregular cycle and what look to be cysts on one ovary).  thanks for any feedback!
    Posted by stefani2[/QUOTE]

    Hi Stefani,
    When I was diagnosed w/PCOS, I still needed to have a minor surgery and a couple of other tests done before the RE would give us the green light for TTC.  At that point, he put me on metformin b/c my glucose/insulin level test results indicated that it could be beneficial.  After being on metformin for a few months, my period still had not come back on its own (I hadn't had a non-provera-induced period for over 6 months!), and we decided to go ahead with the clomid immediately when the RE cleared us for TTC.  Even though I was on the clomid, I still continued with the metformin, so they aren't mutually exclusive.

    If you're in no rush to get pregnant and/or do not want to risk multiples, then I would say to go ahead with the metformin.  You may want to set a time frame and then re-evaluate after a certain number of months whether you want to proceed with clomid.

    If you don't want to wait and want to get pregnant sooner rather than later (and are ok with risking multiples), you could still start with the metformin and just take the clomid too.

    The thing to remember with the clomid is that most RE's won't have you do it for more than 3 cycles since research has shown that if it's going to work, it will work in 3 cycles.  So...if, say, you decide to try the metformin alone for 6 months before trying clomid, and then the clomid doesn't work, then you'll be on to more-invasive things like IUI and IVF.  So you really need to think about whether or not you are willing to add the months of metformin on top of the additional time it could take when/if/after you decide to move on to clomid and if it doesn't work.

    As I said, I went on to clomid as soon as we were "allowed" and I didn't get pregnant until the 3rd cycle.  When I did get pregnant, it was with twins.  Statistically, the risk of twins and triplets is relatively low on clomid, but it does happen.  I seriously never thought it would happen to me, but we were ok with that risk.

    As far as metformin goes, you'll probably feel a little "off" as far as your digestive system goes for a few weeks as you taper on to it, but once you adjust to it, you shouldn't have any problems.  People have various reactions when drinking alcohol while taking metformin.  Some people get REALLY sick, but others don't notice any difference.  I tried to keep my alcohol intake down to a glass of wine with dinner while I was on it and I was completely fine.  I've heard of some people skipping a dose if they're planning to go out partying, but I never did that.

    For the clomid, you may have some pain near your ovaries as they become stimulated and you ovulate, but nothing too bad.  The cycle I got pregnant, my left side near my ovary was VERY tender to the touch for a couple of days, but nothing too painful.  I didn't experience any of the mood swings that some people report while on it.

    Whatever you decide, good luck.  I'm sure it's a relief to get an official diagnosis and to have a "reason" for your irregular cycles. 
     

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