Tuesday, April 29, 2008

Request for Information

Hi Ladies! This is a special shout out to my IF gals. I have a good friend who is not a blogger who has been facing IF. She is double whammied with both PCOS and a balance translocation. Luckily, it seems that Metformin has finally done the trick and she is pregnant in her mid-first trimester. She is a little spooked after talking to her OB about whether or not to continue the Metformin through just the first trimester, or longer throughout the pregnancy. They have not made a decision yet.

I know some of you have been through this issue. Would you mind sharing your decision making process? I understand some circumstances may be different, but I thought I'd check in with you all. She has been through one other pregnancy and I don't believe she had gestational diabetes in that case, nor did she continue the Met.

Thanks for any advice you can offer! And if you'll cross your fingers for her too, I'd appreciate it. (There is still the translocation to worry about too.) Thanks guys!

15 comments:

Leah said...

Unfortunately I've got no experience with Metformin, and therefore can offer no advice. I will, however definitely keep my fingers crossed for her!

G said...

I took metformin throughout my pregancy. My OB wanted me to stay on it for the whole pregnancy to try to avoid gest diabetes. After losing my son at 26 weeks though, I found a hint somewhere (who knows where at this point) about it potentially a contributing factor in stillbirth when taken in 2/3 tris (but really, if you look hard enough you can find stats to support any bad thing - and its definitely not what caused mine). Needless to say, next time through I will taper off completely post 16 weeks and if my OB doesnt support it, I will probably do it anyways. Unless he can provide me with evidence to the contrarty. I dont mean to be scary to your friend, she should do what she feels is right.

G said...

*contrary

And I am sorry, I dont mean to be a total downer and it was totally a Dr Google search... please take it with a grain of salt. Ugh

Leah said...

I also forgot to mention... thank you so much for stroking my ego with the comment. You, much like Farah, are faithful commenters and I can't thank you enough. Please know that I read all of your posts right away, but I'm pretty crappy at commenting every time myself. Just keep in mind that I have you in my prayers every day.

Bee Cee said...

A bit rubbish with pg advice but I have got my fingers crossed for her.

Tash said...

I took metformin through just the first trimester, both pregnancies (which went to term. Superdocs tell me there is no way met had anything to do with Maddy's issues.) I think Julia at "Won't Fear Love" is taking met (or similar) longer, but would have to ask her.

re: translocation -- don't have one, but people I know who do get CVS at 11w to test for it. If she's negative and the blood sugar is down/in control, my guess would be they recommend she go off the met. With a translocation she should be seeing a Mat/Fet anyway, no? They'll be the ones to tell her when to come off everything. They took looks and gave me good timetables when to wean off both met and progesterone.

(Hoping everything's ok with *you*!)

Waiting Amy said...

Thanks to everyone for the helpful info! I really appreciate you guys sharing your knowledge. I think that's the quickest I've gotten so many comments since my BFP!

A.M.S. said...

None of my doctors...and there were plenty...had any issues with my taking met throughout the pregnancy. I still ended up requiring some insulin for a brief period and had to check my blood sugar throughout the day while I was in the hospital on bedrest. I had other things on my mind, so I never really asked about it, but I blame 1)the inactivity of the bedrest 2)the steroids 3)the amount of food they were forcing me to eat to try to get me and the babies to gain weight. At no point did anyone say, "The metformin caused X to happen." If I get pregnant again, I'll probably stay on it throughout.

MrsSpock said...

Back when my Fam Practice doc thought I had PCOS, she was planning on putting me on Met. She told me she usually tapered her OB patients off after 1st trimester.

Fertilized said...

I took met through week 13 of my pregnancy- I did a glucose test at 15 weeks and passed. I took another test for gest diabetes at 28 weeks - and have sionce then been diagnosis'd with it. My dr's do not want to give me my Met back- they told me I can relate ith foods- We'll See. Tell you friend good luck and she can contact me if she wants any specifics

InfertileMadWoman said...

I took Met my whole pregnancy, didn't get GD, and actually had to dose down to keep my blood sugar from going to low at a few points. With women who have PCOS, I have been told by the RE that it tends to cut down on a lot of the insulin issues during pregnancy, and actually has been shown to prevent early losses that PCOS women are prone to. I honestly think that she should strongly consider staying on it.

Julia said...

So the issues with met through pregnancy are that according to the gold standard of placental studies (let me know if you need links), it crosses the placenta. We don't know all the things it does molecularly, and that is why it makes people nervous. On the other hand, everyone (by which I mean high risk OBs all over the country) is sitting around waiting for a pa.per that should be coming out in N.ew En.gland Jo.urnal of Medi.cine about using metformin for gestational diabetes. Based on expecting that paper, my OB and I considered continuing my met longer than the first trimester, but because (according to one of the jou.rnal's edi.tors) the paper isn't coming out for another couple of months (although that was about 8 weeks ago, so maybe soon now) we decided against it. The reason being, while the general conclusion of the paper (that it's a safe thing to do) has leaked out, we don't know what the paper used for outcomes, i.e. whether metabolic studies of any kind were performed on the newborns, or whether just controlling the mother's blood sugar was used as the outcome.

So my recommendation now would be to watch NE.JM up until the end of her first trimester. If the paper appears, read it and act on it (I would be happy to give my opinion on it as well, if you'd like). If it does not, I would go with the current protocol of quitting the met at the first to second trimester line.

Let me know if I can clarify anything further, ok?

Kim said...

I was told to end it at about 12-13weeks by my re and OB. I found a lot to support this, so I followed their advice and had no gest. diabetes.

LIW (Lady In Waiting) said...

I don't have any assvice but I will send your friend loving energy. I can't imagine the fear she must be experiencing given their situation.

And, hey, granted I was only a babysitter at the time, but I lost my cool many times with a preschooler. How could anyone ever be patient all the time?? Impossible!!!

Good luck on selling your house and all of the tasks that go along with it. I am sure it feels overwhelming at this point but just do what you have to. Try not to do everything.

And Ann Taylor Loft Maternity? didn't even know there was one. That could be VERY dangerous. :-)

XOXO

Nix said...

Hi I took Met until the end of the 1st trimester as agreed with my OB, I never had any GD but did land up delivering at 25 weeks due to a completely unrelated compplication.
Another OB told me met can reduce the risk of preterm labour and in one of my (many) preganacy books something similiar is mentioned.