Trying for a baby: polycystic ovariesQ."I have PCO and have been prescribed metformin, but it has not made any difference. What's the next course of treatment? Also, I have a heart-shaped uterus. Will I have to have this operated on before I conceive, as I have heard it can cause miscarriage or premature birth? Is the rate high for this?"A.Metformin is a very modern treatment for the fertility problems encountered with PCO. It is an anti-diabetic drug given because in some cases of PCO the sensitivity to insulin is reduced, so the concentration of insulin needs to be higher. Just how this effects fertility is not completely understood.There are many other ways of treating subfertility in women with PCO including clomiphene tablets, FSH injections, IVF and ovarian diathermy. They all have their advantages and disadvantages and you should discuss all of them with your fertility specialist. I should say, of course, that it is definitely a job for a specialist, not a GP or a general gynaecologist. It sounds romantic to have a heart-shaped uterus. In fact, this is not all that
uncommon. The evidence is that it probably has no relevance at all for fertility and
operations to ‘correct’ it should not be performed. There are, however, more
severe forms of abnormal uteruses which do benefit from surgery. |
