Can Metformin fail to help?

Patient

Q: Hi,
I have been on metformin for a year now. I was diagnosed with early PCOS and my husband and I are TTC for 1 year now. Two cycles of Clomid and Bravelle shots and one IUI and one natural intercourse failed. On my third cycle, after taking Provera for 10 days, I waited 14 days and had no period. An ultrasound showed that my lining was thin enough, so the doc started me on Clomid 100 for 5 days, followed by one shot of Bravelle 150. The follicle slowly grew to 8mm, so a second shot of Bravelle 150 was given to me. The very next day I had bleeding and for two days, I shed bright red blood. It wasn't particularly heavy and stopped after 2 days and 2 nights. Ultrasound showed the lining had thinned considerably but was still 3 layers thick. The follicle was nowhere to be seen. My question is: a) What just happened there? Did I have a period mid-cycle? b) I haven't lost any weight on metformin. I used to have diarrhoea-style stools for several weeks after I started but these have now stabilized. But it doesn't look like metformin has helped at all. I am 5'3" tall and about 205 lbs. Could someone help me figure out what's happening with my body? I should add that I am heavy-boned and do not look as heavy as my lbs suggest, and I started with exercise and carbohydrate-control in the last 2 weeks, which has begun to show good results, I feel - at least emotionally and in terms of my stamina.

Doctor

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