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Have PCOD. Getting Periods While On Medication. Trying To Conceive. Should I Continue Metformin Tablets?
Question: Hello doctor i'm 30 yrs female and i have PCOD for nearly 15 yrs and i get periods only on medication and i'm trying to conceive from 3 yrs.My doctor prescibed me metformin tablets and fertyl super 150 mg and with that i had 1 follicule 18mm in left ovary my follicle ruptured on 21 st day of my periods and now i want to know whether i have to take any medication to sustain or for implantation and do they have any side effects?.What are the chances of conception if i keep relations in these days.My husbands motility is 50 % and count is normal. Also Please advice if i have to continue metformin tablets and do i have to take any other tablets if pregnancy occur...
Hello XXXXXXX,
Firstly, as the follicle ruptured on 21st day of your menstrual cycle, you have to keep relations in these days. In fact it should be from 18 to 24th day of the cycle. It definitely increases the chance of pregnancy. Because, rupture of a follicle indicates release of ovum. If you keep relation on and around that day then theoretically there is higher chance of conception.
Now, in pregnancy, progesterone is the most important hormone which together with estrogen simulates growth of uterus, causes decidual changes of endometrium required for implantation and it inhibits myometrial contraction. By doing this, it prevents the spontaneous miscarriage.
So, you have to take preogesterone group of drug (like dydrogesterone) to sustain the implantation of product of conception. It can be taken during pregnancy. It has no harmful effect on the fetus. It has few side effects like hypersensitivity. Gastrointestinal disorder, headache, emotional lability, irritation, etc.
Your husband's motility is within normal limit ( normal active + sluggishly motile perm > 50% as per WHO1999). So, from that angle there is no problem.
In PCOD, the peripheral resistance to insulin is increased causing hyperglycemia. So, you have to take metformin. Because increased blood sugar level ha bad effect on pregnancy. You can take it during pregnancy also. And gradually, considering situations during pregnancy necessary measure should be taken.
If pregnancy occurs, apart from the usual drug you are taking you have to take only tablet containing Iron and Folic acid. If you have any pregnancy related complication, only then you have to take specific medicine.
Hope this information suffices. Let me know if you have any more question.
Regards.
Firstly, as the follicle ruptured on 21st day of your menstrual cycle, you have to keep relations in these days. In fact it should be from 18 to 24th day of the cycle. It definitely increases the chance of pregnancy. Because, rupture of a follicle indicates release of ovum. If you keep relation on and around that day then theoretically there is higher chance of conception.
Now, in pregnancy, progesterone is the most important hormone which together with estrogen simulates growth of uterus, causes decidual changes of endometrium required for implantation and it inhibits myometrial contraction. By doing this, it prevents the spontaneous miscarriage.
So, you have to take preogesterone group of drug (like dydrogesterone) to sustain the implantation of product of conception. It can be taken during pregnancy. It has no harmful effect on the fetus. It has few side effects like hypersensitivity. Gastrointestinal disorder, headache, emotional lability, irritation, etc.
Your husband's motility is within normal limit ( normal active + sluggishly motile perm > 50% as per WHO1999). So, from that angle there is no problem.
In PCOD, the peripheral resistance to insulin is increased causing hyperglycemia. So, you have to take metformin. Because increased blood sugar level ha bad effect on pregnancy. You can take it during pregnancy also. And gradually, considering situations during pregnancy necessary measure should be taken.
If pregnancy occurs, apart from the usual drug you are taking you have to take only tablet containing Iron and Folic acid. If you have any pregnancy related complication, only then you have to take specific medicine.
Hope this information suffices. Let me know if you have any more question.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doc.thank you for ur reply however as u have suggested to take preogesterone group of drug (like dydrogesterone) would like to know th exact dosage and how many days it should be taken and starting from which day..Is there any other drug similarly by some other brand name if in case this is not available.Also plz confirm whether a gynaec would recommend me the same medicines.if i dont get pregnant still what would be the reason?My husband usually gets tired a lot so is there medicine for increasing the physical stamina.
Hello XXXXXXX,
Thank you for writing back.
Firstly here, we cannot mention any particular trade name. As I previously told you for this particular drug, you have to consult with your treating doctor first about this recommendation, and the doctor will prescribe the drug according to your condition. Like, it is generally given after the rupture of follicle. Some times it is also given as a maintenance dose. It can be taken upto 20 weeks of pregnancy. After this age, dose is maintained according to the situation.
Now, getting pregnant is largely dependent on chance factor. It cannot be said with guarantee, that - after doing all these things you will get pregnant. In my opinion, as the follicle get a 18 mm size , it can be said that there is high chance of pregnancy.
The reasons would be anything - hormonal disbalance, low motility of sperm, failure to implant.
For your husband, a multivitamin alongwith micronutrients is appropriate.
Hope, you have your answers.
Regards.
Thank you for writing back.
Firstly here, we cannot mention any particular trade name. As I previously told you for this particular drug, you have to consult with your treating doctor first about this recommendation, and the doctor will prescribe the drug according to your condition. Like, it is generally given after the rupture of follicle. Some times it is also given as a maintenance dose. It can be taken upto 20 weeks of pregnancy. After this age, dose is maintained according to the situation.
Now, getting pregnant is largely dependent on chance factor. It cannot be said with guarantee, that - after doing all these things you will get pregnant. In my opinion, as the follicle get a 18 mm size , it can be said that there is high chance of pregnancy.
The reasons would be anything - hormonal disbalance, low motility of sperm, failure to implant.
For your husband, a multivitamin alongwith micronutrients is appropriate.
Hope, you have your answers.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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