Patient :I am trying to get pregnant so I went to the ob-gyn. After running many exams (blood work as well as ovarian and uterine ultrasound) he verified that everything was normal, except that I had high levels of prolactin and so prescribed me with Dostinex (cabergoline) 0,25 mg per week. Also, he gave me Clomid to be taken for 4 cycles between the 3-7th day of each cycle.
On the same week, I went to visit an endocrinologist. She ran lots of bloodwork and said I had metabolic syndrome because of my high colesterol and high triglycerides. She told me I could be having difficulty getting pregnant because of this and told me not to start clomid. She then gave me rosuvastatin for the cholesterol and metformin for insulin resistance, as well as a diet. I have been following the diet for over a month and already lost some weight. Nevertheless, I do not like the idea of rosuvastatin, as I heard that it has serious side effects and can cause liver damage, especially in asian populations.
I would like to resume trying to get pregnant (I am 33 years old) and therefore I would like to interrupt the rosuvastatin since I heard It cannot be taken if you are trying to get or are pregnant.
My question is: can I start taking the Clomid and interrupt the rosuvastatin? Should I interrupt the metformin or is it safe to use during an eventual pregnancy?
My two doctors won't agree. One thinks its safe to go ahead and get pregnant even after seeing all my bloodworm (he does not know I went to the endocrine and she gave me rosuvastatin and metformin). The other doctor says I should stop trying for now.
I am running out of time to get pregnant and now is a window in my life in which it would be ideal.
Thanks for the query to ATD for an opinion,
As I learnt from the history that you were diagnosed to have hyperprolactinemia which is often a cause of delayed menses and anovulatory cycles and hence you have been advised cabergoline 0.25mg weekly. the levels of prolactin generally settle down by 3 weeks and ovulation can be expected from the next cycle onwards. If all other tests have been negative and there have been no polycystic features in ovary, then it's a good sign indeed. However, it is a known fact that obesity if present ( BMI more than 25) then it again increases insulin resistance in the body which can deter ovulation again. So when your endocrinologist says that you have a metabolic syndrome he is right in his own way but when the concern is getting pregnant, then of course the opinion differs between gynaecologist and endocrinologist.
You should stop rosuvastatin as its a hypolipidemic drug and as such is not a safe drug in pregnancy especially in early trimester if you get pregnant. You can continue metformin as its safe and cabergoline as well weekly. Clomifene can be started from next cycle as it shall help in follicular growth under an anovulatory environment ( preferred treatment even in cases of PCOS), so you should start without any concern. Weight reduction by 5% itself increases the chances of ovulation by 20% so keep your BMI in check.
I hope i have answered your query and concerns in detail,
Wishing you good health,
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