QuestionI've went through a cycle of T.I. with repronex to force ovulation which didn't work, I do not have PCOS, from what I understood my hormone levels are low and I think I don't ovulate on my own. I've moved so I can't see that fertility specialist and I have to see a new one. My new family doctor told me that there have been successes with Metformin. I am wondering if I would be a possible candidate to use Metformin or if it is only used with PCOS patients? I was supposed to try the T.I. again before resorting to IVF. I cannot afford IVF and am hoping that some other treatment may work for me. I responded well to the Repronex and had I believe 15 follicles (i think that is the right term) but for whatever reason it didn't work. I really don't want to have to go through the month and 1/2 of injections again, but will do so if that would be the better course of action instead of using Metformin. Any advice would be greatly appreciated. My specialist was in TN but I am in Virginia now and need to find a new specialist, so if you have any advice in that area that would be greatly appreciated too.
Thank you.
AnswerHello Jennifer from the U.S.,
If you don't have PCOS then Metformin would do nothing for your fertility. In fact, your FP doc is WRONG in advising it. Only 40% of PCOS patient respond to Metformin and it should only be used in PCOS patients that have ovarian resistance, NOT all PCOS patients. That is the type of "blanket" advice that I don't like to see doctors giving.
You mentioned that your hormone levels were low. How low? There is a disorder whereby the brain does not produce adequate FSH and LH hormones for ovulation to occur. This is completely different from PCOS. It is called hypogodadotrophic hypogonadism. If that is the case, you would need to take a fertility medication such as Repronex or Menopur because it has both FSH and LH. Those are the hormones that the brain usually produces to stimulate the ovary to ovulate. If it is the case that you have inadequate levels of these hormones, then the injectable is a requirement. But, you don't necessarily have to do IVF, since the only problem is ovulation, you could just do ovulation induction with timed intercourse or IUI.
The Jones institute is in Virginia. It is the oldest IVF center in the U.S. and an excellent program. I'm sure there are a number of other specialty clinics there as well. I'm afraid I don't have any that I can refer you to specifically.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV
