The issue isn't the diagnosis of diabetes or
PCOS,
but of the safety of the medication during pregnancy.
Metformin
(like many other medications) has not been extensively studied during pregnancy in the rigorous fashion that the FDA requires for obtaining an "indication" that
it's okay to use during that time. However, it has been used for many years in some parts of the world during pregnancy (see for instance
Metformin therapy and diabetes in pregnancy
I don't understand why your doctor would feel comfortable with you taking metformin during early pregnancy, when fetal organs are forming, then
suggests discontinuing it after that period: ask him.
wwq
There is a recent review of the use of metformin
entitled
Metformin in Obstetric and Gynecologic Practice: A Review.
in the
Obstetrical and
Gynecological Survey, vol 59, number 2, p118-127.
The last part of the
abstract states
There is a large volume of research supporting the use
of metformin treatment in diabetes mellitus, androgenization, anovulation,
infertility and recurrent miscarriage. Although metformin is known to
cross the placenta, there is, as yet no evidence of teratogenicity.
Metformin has an array of complex actions, accounting for the varied
clinical roles, many of which are still to be fully evaluated. Much
research is still needed.
My own experience has been from referrals of women with PCOS who have been
managed by infertility specialists and are newly pregnant. Their doctor
has recommended that they continue the use of metformin due to some
evidence that it may reduce miscarriages and perhaps the development of
gestational diabetes. I caution the patients that the studies supporting
this are limited. However, many of these patients have struggled to
achieve a pregnancy and are reluctant to stop therapy. Thus, I continue
therapy with caution, but have yet to see a bad outcome.
owj
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