Should I continue taking Metformin in my pregnancy?

Q: I have been on Metformin for about 5 months. I am 4 weeks pregnant, due to one round of Clomid. My doctor never said if I should stay on Metformin or not. I was told I needed Metformin to aid ovulation and getting my periods on track. Please advise.

A:I discontinue Metformin in my patients once cardiac activity is documented by ultrasound - usually by 7 weeks. Some gynaecologists opt for continuing Metformin if the Fasting insulin levels were documented to be high before Metformin, and normalised after treatment. Even in such situations, I believe it is better to consult the endocrinologist for expert opinion. In any case, I wonder how 500mg of Metformin worked for you. The dosage prescribed is at least 1gm per day.