PCOS and achieving pregnancy
After years of believing she would never become pregnant, Sally Field, a 33 year old with PCOS, gave birth to a baby daughter. This is her story.
"After scanning the internet for links between a low GI diet and managing PCOS, I came across a website (www.diagnosemefirst.com) which I read with great interest. It asked for people to contact them if they have become pregnant after following a low GI diet together with Metformin and I thought you may be interested in my story.
"I am 33 years old and have PCOS. Six months ago I gave birth to a baby daughter, something for many years I never believed would ever happen. Having had amenorrhea since my late teens, I had been put on Dianette with Cytoperone Acetate for to regularlise my cycle and to control the symptoms of PCOS. I sought clinical help straight away after getting married as I knew that without an ovulatory cycle I could not become pregnant.
"On the second cycle of Clomid, I became pregnant, however I miscarried at 7 weeks. I resumed Clomid. However the same and multiple doses of Clomid did not result in any follicle stimulation and therefore after some 12 months, I abandoned Clomid for IVF and also started to take Metformin. To cut a long story short, I went through 4 full cycles of IVF, 2 cancelled IVF cycles due to risk of OHSS (one of these resulted in approx. 80 follicles on my ovaries due to only a half ampoule increase of Menagon from 0.5 to 1 ampoule), ovarian diathermy which made no difference and a further miscarriage. After the last miscarriage, I decided to research other methods of trying to become pregnant as I clearly was having no luck with conventional treatment. After much investigation to the causes of PCOS, I put myself back on to Metformin (although before this had not resulted in any difference whatsoever) however this time I combined it with a reduced carbohydrate diet as I decided this would reduce the impact of insulin resistance.
"Basically, within 5 weeks of this regime, I had a natural period - the first since I was 17 years old. A cycle followed every 4-6 weeks and in short, within 5 months I discovered I was pregnant and this time carried to term.
"Having read more about the diet influence on PCOS, I now firmly believe that although the reduced carbohydrate diet kick-started my body into action, with the help of Metformin, a low GI-diet is more favourable for long-term health and also more sustainable as it is less restrictive.
"After years of painful, intrusive and not to mention expensive fertility treatment and I keep asking myself why the Lister Hospital (where I received treatment) and ARGC (where I was about to receive further treatment before discovering I was pregnant) do not promote the idea of adopting a reduced carb or preferably a low GI diet for sufferers of PCOS before embarking on any type of fertility treatment. Surely even if this doesn't work alone, alongside IVF could there not be a higher success rate as the body is more balanced? It frustrates me to think other sufferers are unaware of potentially how easy it is to break the vicious circle of PCOS as I discovered on my own. Is the link between a low GI diet and PCOS a relatively new idea or would have this idea been known about over the last 5 years when I received treatment? I am just very surprised why none of my consultants referred to this as part of my treatment and would be very grateful for your thoughts.
"I found the website (www.diagnosemefirst.com) extremely interesting and only wish I stumbled on it some 5 years ago! I would be very happy for you to use my story as I would be very pleased to know that others might benefit from hearing it."
Update on 13 March 2006
Sally Field wrote:
I have polycystic ovaries and after many years of fertility treatment (numerous cycles of Clomid plus 4 x failed IVF) and two miscarriages, I finally conceived and carried to term after adopting a low-GI diet together with Metformin which resumed my natural cycle (after approx. 16 years of ammenorhea). During this pregnancy, I continued to take 500mg of Metformin tds until 34 weeks as advised by my then consultant.
I am now pregnant again with my second child (having continued with the low-GI diet and Metformin) and as I have since moved area, I am now seeing a different consultant. This new consultant is happy to prescribe the drug if that is what I wish (as I took it during my previous pregnancy), although he said that he would normally not prescribe Metformin at all during pregnancy. I have heard of other people taking Metformin until 12 weeks (as I think you indicate in your website) but wondered what your opinion of taking it until 34 weeks is? I would be very grateful for your input.
Prof. Farid response:
You are correct that we recommend metformin to 12 weeks of pregnancy and advocate strict low GI eating for the balance of pregnancies, but with a gradual increase in calories.There are two or three good studies from the USA that have used the drug throughout the pregnancy with no deleterious effect on mother or baby. Historical evidence from developing countries where metformin is an affordable sugar lowering agent in women with gestational diabetes had suggested that metformin was probably safe
The problem is that when the woman is found to have an abnormal GTT 24-28 weeks of pregnancy, the only acceptable way to manage that is either strict diet (low GI) or insulin, hence the dilemma.
I have no doubt that it is only a matter of time before control trial are organized to address this issue!