Q: I am a 28 years old woman weighing 62 kg and my height is 5.1 feet. I had two missed abortions in a span of 1 year, both at gestation of around 10 weeks. Both the times I conceived spontaneously. I have regular cycles at 32 days. I have a hair pattern suggestive of hirsutism. After my first miscarriage, all my investigations were normal. My LH and FSH were in the normal range as on the third day of menstrual cycle, however their ratio was more than 1:1 (LH, FSH). During my second pregnancy my left ovary appeared polycystic with a typical appearance (string of pearls). The gynaecologists attributes these missed abortions to PCOS so she suggested Metformin. I am trying to lose weight too. What are my chances of having a successful pregnancy? Should Metformin be continued during pregnancy?

A:Yes, Metformin is ok - you will also need to check for egg formation, by transvaginal scanning of the ovaries - if there is a problem then drugs like Clomid will need to be given in addition with simultaneous scanning for eggs and timing sex with egg rupture - for further increasing chances of pregnancy. Success can be achieved in over 60% cases. In your case after pregnancy is achieved you will need more care to prevent abortion - that is by adding folic acid, rest, nutrition rich in proteins and vitamin supplements, no sex for first three to four months and vaginal progesterone suppositories to keep the uterus soft and relaxed - all stress needs to be avoided.