Metformin dosage increase

[dimples09]

I am a 29yr femalen and I am ttc I had all the blood work done and its showing I have PCOS. I was put on metformin 500mg last month and had one cycle of femara 2.5mg and my doctor said it was not working as fast as he wanted to accoriding to the u/s. He said my PCOS was still hindering my ovaries from working properly.So I am going to see a specialist next week. He also increased the metformin to 1000mg and it will increase again on the 14th to 1500mg. I had a progesterone test on cd 20 and it was 8.7ng/ml is this in the normal range? Three days 5/9/09 later AF arrived unexpectedly she wasn't suppose to show until 5/16/09. Do you think that the increase in metformin made her come early or might I have a luteal phase defect/problem with my progesterone levels?

[dimples09]

Thank You for your answer from my first post. I'm just so confused and hurt adn all these other emotions that I forgot to tell you that.
Thank You.

[dimples09]

Ok. I went to the specialist and had a u/s she said that I had lots of follicles with eggs but they are not large enough. I'm on cd 10. She said that we are going to increase the femara to 7.5mg to take on cd 3-7 because the 2.5mg was not doing anything. I am on 1500 mg metformin do you think I should have asked her if that needed to be increased also? She told me that I may need to be on the increased femara and get a HCG trigger shot. Am I ovulating or am I just getting a period? Or does the egg not being released turn into the cysts on the ovaries which is PCOS?

[Elaine Brown, MD]

HI!
Your progesterone level is "OK". We like to see them above 14, ideally, but 8 should indicate that you ovulated.  Also, the fact that you had your menstrual period suggests that you ovulated.  Its possible that the Metformin stimulated you to ovulate, despite the fact that you were on Femara.  Normally, ovulation should be on exactly day 28 if Femara is take on CD 3-7.  One other possibility is that you had an excessive build up in the lining from previous irregular periods, and it is just shedding early.

Whatever the case, it was probably good to clean out your lining and start again.  Hope the specialist has some insite, it sounds like your regular MD was on the right track!

Good luck!
Dr B