[DianaG]

Hi. My name is Diana. I have know I have PCO since I was 14, but was not diagnosed until I was 20. Unfortunately, I was treated by my gyno with just putting me on BCP's for 10years. I didn't know enough about PCO to see that that was a huge mistake. My cycles were regular and I thought everything was fine until 1995 when I stopped taking my bcp because DH and I decided to try to start a family. That was almost 9 years ago.

In the past 16 mos I have suffered three miscarriages. I am awaiting my third right now. I was notified on the 2nd that this pregnancy was lost and am still waiting as I watch my numbers decrease with each bloodtest.

I was diagnosed with type two diabetes in Sept. of 2001 when I had my first m/c. I have since been following a diabetic meal plan and my bloodsugars are fantastic. My doctor says that I have very tight control. However, I am still miscarrying. I have had many tests done concerning immune disorders or clotting issues, and they are all coming back negative as to the different causes of my miscarriages.

I cannot help but think it is related to my PCO and I am wondering if I shouldn't try a different diet approach. Maybe somehow I am not getting enought vitamins and nutrients with the type II meal plan I am on.

My question for any PCO moms is : What sort of meal plan were you on prior to conception and during your pregnancies?

We want to try again, but I am very afraid of a 4th loss and I guess I just feel helpless right now, and diet is one area that I can control.

The glucophage that I am on is helping immensely with my other PCO symptoms, such as hair and acne. However, I still need clomid to ovulate.

I look forward to learning from all of you and am so happy to have found a place where I can talk to other women who are dealing with PCO on a daily basis.
Best Wishes,
Diana

[GreatBigMonsterMomma]

Diana, I'm sorry for your loss.

I was not on any special eating plan when I got pregnant. And when I was pregnant, I counted myself lucky to keep my dinner down.

I have never heard of PCO being linked to miscarriage, but it wouldn't surprise me if it was. Are you taking a prenatal vitamin? That can take care of a lot of nutritional deficiencies.

Am I right in assuming that you've been checked for a progesterone deficiency? Apparently, that commonly plagues women with this disorder.

This is the info I've found on PCO & miscarriage. It's from INCIID PCOS FAQs, which I urge you to check out. The site itself has info on infertility in general which you might find helpful.

6.1 Is the miscarriage rate higher in women with PCOS?

There does appear to be a higher miscarriage rate in women with PCOS, but the exact reason is still under investigation. According to some studies, the risk of miscarriage in women with PCOS is 45 percent or more. One possibility is that early loss is associated with elevated levels of luteinizing hormone — and women with PCOS often have elevated LH levels — but the reason why it relates to miscarriage is not understood. Another possibility is that elevated levels of insulin or glucose may impede implantation or cause problems with the embryonic development. There is a clear association between uncontrolled blood sugar and pregnancy loss, but the issue of insulin resistance and elevated insulin levels is relatively new and in need of further study. There is a possibility that insulin resistance reduces egg quality. That leads to another possibility — that late ovulation (after cycle day 16) may be associated with poor follicle development and decreased egg quality.

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6.2 Is there anything that can be done to reduce the chance of miscarriage in a woman with PCOS?

The primary way to reduce miscarriage associated with PCOS is to normalize hormone levels. For women with low progesterone levels in the luteal phase, improving ovulation through the use of clomiphene citrate, or injectable FSH or FSH/LH may help the problem. Addressing ovulation issues is more useful than progesterone supplementation as low progesterone is usually a symptom of a problem, such a weak ovulation, rather than the actual cause of miscarriage. Normalizing blood sugar and glucose levels may help, and lead to lower androgen levels, so use of metformin (see next question) during pregnancy is increasing. Most doctors would have patients discontinue use of the glitazones.

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6.3 Can metformin reduce the chance of miscarriage?

It appears that continuing metformin use at least through early pregnancy may reduce the chance of miscarriage, especially in patients with recurrent losses. A recent abstract, "Metformin throughout pregnancy in women with polycystic ovary syndrome reduces first-trimester miscarriage" (CJ Glueck et al, J Invest Med 2000), revealed a group's experience with 59 pregnant PCOS women. Of these, 23 were kept on metformin for the long haul. The other 36 did not continue metformin in pregnancy. This is a very small sample, but the miscarriage rate was 45 percent without metformin and only nine percent with metformin. Chi-square testing showed these rates to be highly significant from a statistical point of view, but their true clinical impact must await further prospective studies. As with any medication used in pregnancy, doctor and patient must assess whether the benefit outweighs any potential risk.

SO that might be a cause for your miscarriages. I know that diabetes in & of itself negatively impacts fertility, and since you're insulin-dependant I'm certain that factors in there too. Another thing for your doctor to check if he hasn't yet is the thickness of your uterine lining. This is an important part of successfully carrying a pregnancy, but it is sometimes overlooked. If your lining is too thin, implantation cannot occur, and will result in a miscarriage.

Best of luck to you in finding out what the cause is. Please keep us updated!

[Melissa70]

Diane I am sorry for your loss Have u ever had your progesterone levels checked after concieving? U could have Low Progesterone levels. Just a thought.. good Luck in the future hun*hugs*

[RunnerDuck]

Want to second getting your progesterone checked - low progesterone often leads to miscarriage w/ PCOS. A lot of women find that all they need to a progesterone supplement for the first few weeks/months and then they are fine.

Sounds like between the glucophage and good diet work, you are really already doing your best. I never heard of a vitamin or mineral that could help with miscarriage loss -

EXCEPT you might want to know that glucophage can decrease your absorbion of B vitamins and folic acid. You might want to get extra of these. Folic acid deficiency can cause birth defects - some early miscarriages occur because the fetus was not fit to thrive - it is POSSIBLE, I suppose, that this could be the culpret.

But number one is to have progesterone checked as soon as you know you are preggers. What sort of doctor is treating you? If this has not been standard I would assume he/she is not all that knowledgable about PCOS and perhaps you should find someone better.

As for BCPs only for 10 years... don't worry, we've all been there. Until recently, not many doctors seemed to know much at all about PCOS. Glucophage as a real treatment has only recently come into the foreground with most doctors, so BCPs have always been the easy way out for them.