Infertility/Fertility/2 miscarrages



I am 38 yrs old, have always had regular periods but have pcoS.  I am slightly overweight and have hirtuism. I take 500 mg of metaformin increased only recently to 1000mg. I got married 2 yrs ago but only recently have tried to get pregnant.  I tried 2 times, trying to conceive during ovulation.  I achieved this both by measuring basal body temperature and an ovulation test.  Both times i got pregnant but miscarried, the first time at 5 weeks and the second at 8 weeks nearly 9.  However the 2nd preg there wasno heartbeat or baby at 6 wksI am really not understanding this.. if i get pregnant why does the baby gets miscarried?  Can you help me?

Hello MCSZ from Malta,

The most common reason for miscarriage is that the embryo/fetus is abnormal.  And, the most common reason for the abnormalities is a spontaneous error when the embryo is dividing and the fetus is developing.  This incidence increases with age.  As an example, the risks and incidence of Down's syndrome, a genetic abnormality of the 21st chromosome is 1/150 at your age and 1/100 at age 40.  Down's syndrome babies are born because it is a minor abnormality of only one chromosome.  Most other abnormalities are multi-chromosomal and therefore not compatible with life.  Studies have shown that after the age of 36, the incidence of miscarriages is as high as 50% of pregnancies.  This is most likely the reason you are miscarrying and should expect that this may continue to occur.  Eventually, however, you may be successful.

By the way, if you have regular and predictable menstrual cycles, by definition, you do not have PCO.  PCO, by definition, is an ovarian dysfunction so in order to have this diagnosis, you have to have anovulatory/irregular menstrual cycles.  Secondly, the correct effective dosage for Metformin is 1500 mg per day.  Are you sure about your doctor?

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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