Expert: Scott Roseff, MD, FACOG - 3/21/2004

Question
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Followup To
Question -
Dr. Roseff,

I am currently on my third cycle of clomid.  The first month, I took 100mg CD 5-10, and also took 500mg QD metformin.  I do not have PCOS or any type of insulin resistance.  That cycle, only one dominant follicle formed.  No luck.  Next month, I again took 100mg clomid cd 5-10 and DID NOT take the metformin as my RE said.  That time, I had 9 follicles... thought for sure I'd get pregnant with multiples in fact.  No luck again.  This cycle, I am doing the same 100mg clomid CD 5-10, and again added the metformin of 500mg QD along with it.  I am nervous though because this time, I'm not having any of the side effects of the clomid taking effect, such as the bloating and abdominal pain I had last month, which signaled to me that it was working.  Can metformin make clomid less effective?  Other than that, nothing else is different between all the cycles.  I appreciate your advice.  Thank you.
Answer -
Colleen - There's a possibility that someone can make several follicles/eggs with Clomid, and then the addition of metformin may decrease that to only one.  If you don't have IR, then why would you be taking metformin in the first place?

Are you SURE you're seeing a board certified RE?

Dr. Roseff - Director of W.E. C.A.R.E. in West Orange, NJ
Personalized/Individualized Successful care by a solo practice specialist in a warm and caring setting....
www.reproendo.com
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Since I don't know your entire history and haven't examined you, any medical information given to you may be incomplete or inaccurate.
Therefore, Dr. Roseff and the W.E. C.A.R.E. staff can not be responsible for any actions taken or not due to the information contained within these communications. These communications are for educational and informational purposes only, and should never be used to replace the information and care rendered by your own doctor. No part of this message may be reproduced, printed, or posted anywhere else without the express written authorization of Dr. Roseff.
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Thank you for your prompt reply, Dr. Roseff.  I did not take the metformin again last night.  So in all, I took 500mg metformin for 4 days, and took clomid 100mg for 6 days.  Do you still think the metformin will interfere, or lessen the efficacy of the clomid.  This is my third cycle on clomid and RE says it's the last he'll do.  FYI, the reason for my annovulation is that I used to suffer from anorexia and for years, did not have a period on my own.  I have since gained 20 lb. and am at healthy weight, but my periods just aren't back to normal.  I want this to work SO BADLY!!!  Any advice is more than appreciated.  Thank you!

Answer
Hi Colleen,
Not knowing your entire history, it's impossible for me to tell you if you're on the right path or not by taking Clomid for the unusual duration of 6 days.  Also, do you not ovulate on 50 mg Clomid?  Why start with the higher 100 mg dose?  I also can't tell you if you are an appropriate candidate for metformin or not, as it's generally presribed for women with insulin resistance or diabetes or PCOS...  Finally, I'm still wondering if you are seeing a board certified RE or not....

Dr. Roseff - Director of W.E. C.A.R.E. in West Orange, NJ
If you were coming HERE, you may have been pregnant already!  Visit us and see why at:
www.reproendo.com/different.htm
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Since I don't know your entire history and haven't examined you, any medical information given to you may be incomplete or inaccurate.
Therefore, Dr. Roseff and the W.E. C.A.R.E. staff can not be responsible for any actions taken or not due to the information contained within these communications. These communications are for educational and informational purposes only, and should never be used to replace the information and care rendered by your own doctor. No part of this message may be reproduced, printed, or posted anywhere else without the express written authorization of Dr. Roseff.
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