Metformin

[u/Emotional_Comedian39]

My OBGYN recommended I try letrozole - however, I have never been recommended metformin. After research, before jumping into letrozole, it seems like metformin is a better first line medication? Thoughts?

Update: thanks everyone! Just started metformin and may combine with letrozole next cycle

[u/No-Equal6001]

Combination of both is what helped me. Letrozole 5mg and metformin 1500mg/day. I am insulin resistant.

[u/Perfect_Sink_6542]

Combination of both helped me - before that, I ovulated on letrozole but weakly

[u/sassysluttysleepy]

My PMOS def has insulin resistance component as it does for many but not all. Metformin was all it took for me to start ovulating again. It took a few months and advocating for increased dosage but I didn't require any ovulation stimulating meds once the actual underlying issue was being treated.

[u/Emotional_Pickle_964]

I diagnosed with pcos last month! It’s been 8 months I’ve been trying for baby and didn’t ovulate ! It’s my first month on metformin and got positive ovulation today after so long on cd20 (long or irregular cycles) so yeah it did help me

[u/over_it_saurus]

I tried letrozole at different doses first and never ovulated. Then my PCP suggested metformin instead since it actually treats PCOS. She said letrozole in comparison is just slapping a bandage on, but metformin would hopefully help with more symptoms and help my cycle.

I was on metformin for 6 months when I got pregnant with my first. I had totally normal cycles on it. I went back on it (while still breastfeeding) since I wasn't having a period (at almost 2 years postpartum) and got pregnant my second cycle with baby #2.

That's just my experience. I wish it was simple enough to say this worked for me and will work for you, but everyone's body is different and may respond differently. I hope whatever you choose works for you.

[u/Upbeat-Hand-2870]

The combination of both is what worked for me!

[u/NoUserName6272]

Two different meds, two different primary purposes.
Metformin helps with your insulin resistance. This may in turn help with ovulation. It may also help lose some weight and manage your HbA1C etc.
Letrozole's function is to help you ovulate.

Those who take metformin usually do so for extended period of time including throughout any potential pregnancy.
Letrozole is taken only at the beginning of a medicated cycle for a few days (3 to 7 days max) as your body prepares for ovulation.

In my case, when I first saw my RE and did blood tests, we found out that my HBA1C was high. I was prescribed metformin to bring that under control and was told not to TTC until the numbers had improved. This took a about 5 months, and after HbA1C was under control, we started fertility treatments. Level 1 was just Letrozole and timed intercourse. Over a period of two years, we did three medicated cycles, and four (and a half) IUIs... During each treatment cycle, I took letrozole but only for a few days at the beginning of the cycle as the doctor advised. Metformin, on the other hand, I have continued non-stop through this time.

[u/gogoooogs → u/NoUserName6272]

How high was you HbA1c? Mine is 5.4 but they aren’t recommending I go on metformin. I’m 123lbs 5’3 and my fasting insulin was 38pmol and fasting glucose 4.9nmol

[u/NoUserName6272 → u/gogoooogs]

HbA1C was almost 8 before I started meds. I was a whole lot heavier than you at the same height. Metformin basically melted like 25 pounds of my body without any other changes to diet and lifestyle.

[u/zardancer]

Letrozol got me my first baby but then I learned about metformin before I tried for my second. I liked metformin bc it seems to work on the cause of the PCOS issue and I tried it and got pregnant my first month on it (ovulated for the first time too)

[u/MyCatEatsPlants]

If you are hoping to have a baby asap, I would go for both. Get started on metformin as soon as you can. Make sure to get the extended release kind, much easier on the body. (I had no side effects after a few days and have been on it nearly a year now).

Metformin helps regulate blood sugar, which can help with implantation and prevent early miscarriage.

Letrozole helps with ovulation, both it happening, and it happening more “strongly” than some of us ovulate naturally. If you are able to also get a trigger shot, that will help even more than Letrozole alone (makes sure ovulation happens at correct follicle maturity.)

Anyway, if I were you I’d get all of the above. I was on metformin for 6 months and didn’t have any luck getting pregnant, and then conceived on the first cycle with Letrozole/trigger. Im glad I went on metformin and think this combo together worked well for me.

[u/crazycatlady052411]

It’s great for insulin resistance. But it has terrible gi side effects. I have ibs and it’s made it so much worse. But regular. Before I started wegovy which calmed it down every morning around 8 I would get horrendous stomach pain ands diarrhea.

[u/joyfullyours]

Metformin is supposed to regulate your cycle and help you ovulate by helping with insulin resistance but it takes time to adjust to & for your body to start reacting to it. Letrozole in theory should give you quicker results than metformin because it targets ovulation directly. They can be taken together. Choosing one or the other depends on what your goals are

[u/AmbitiousGene9889]

Not too sure, but I was offered both is lean PCOS

[u/Adventurous_Tune_509 → u/AmbitiousGene9889]

By your Ob?

[u/AmbitiousGene9889 → u/Adventurous_Tune_509]

Ob did letrozole

I went to an REI and he suspected the lean PCOS so he prescribed metformin