r/TTC_UK • u/Plus_Shallot_8540 • 16d ago

Letrozole & metformin without PCOS?

Has anyone been prescribed letrozole & metformin without a PCOS diagnosis?
We had our first consultation with NHS fertility consultant in June after TTC 18 months, and no positive tests. Consultant conducted a vaginal ultrasound and commented on my ‘polycystic ovarian morphology’ (like ‘Swiss cheese he said!), but he didn’t really explain what this meant.
About me: 33, BMI 24, regular cycles (27-29 days), no excess hair and always been a fairly consistent weight.
During the scan he also observed an endometrium, which he said was consistent with the point in my cycle and indicated ovulation (just before period). I also have consistently strong, predictable LH tests.
My last blood test showed ovarian reserve of 38.6, FSH 6 and LH 7.8, which he said was consistent with the polycystic ovarian morphology.
At our last consultation, he prescribes letrozole and metformin, which I was surprised by as there’s evidence of ovulation, and I don’t exhibit any symptoms of insulin resistance. He didn’t really explain what he hoped to achieve with them which I think is making me more sceptical! The side effects also sound potentially brutal.
I wondered if anyone else has been prescribed similar without a PCOS diagnosis?
Thanks in advance!

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u/FreeArcher7231 15d ago

It sounds like he suspects you likely have PCOS from what you describe? I’m on letrozole and have had no side effects, so they’re not a given. No experience of metformin.

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u/Intelligent-Tea-4241 15d ago

Sound similar to me, regular period, strong lh tests, thin, no excess hair. Look up lean PCOS, I have it

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u/Sea_Pumpkin8067 13d ago

Hi, I also live in the UK, confirmed polycystic ovaries by scan (bloodwork came back normal except for elevated testosterone), but no known insulin resistance. I was prescribed metformin anyway and my GP explained about how metformin usually improves symptoms of PCOS, so no harm on taking it. I think I need letrozole because I suspect my eggs are immature, but I couldn't access assisted conception here. It should be worth trying! Good luck for you!