Reply to "mild" PCOS, do i need metformin? insulin resistance?

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[quote=jkimtysons]I was told that I didn't have PCOS because I'm thin and don't have the acne/male-related characteristics, have my period (33-35 day cycle), and ovulate monthly (confirmed via temping). Lo and behold, I have an AFC of 38 with the infamous "string of pearls" and high (18) AMH. Doctor now says I may have mild PCOS. I was anovulatory in college, but chalked it up to stress. Menstruated fine before that and then later on though. Age 34, no kids yet. Day 3 LH is 10, LH to FSH ratio s 1.3, so under the 2+ range that is indicative of PCOS.

So now I'm reading all about mild/lean PCOS, and metformin keeps popping up. Some people say that it's a must to prevent miscarriage/boost egg quality, others seem to prescribe a "wait and see." It seems to be most common for traditional PCOS symptoms, less so for mild/questionable cases, especially for those who ovulate on their own--but then some people still say that it's important. Not sure what to make of all of it. I don't think I'm insulin resistant--although I guess I could be even though I don't have the accompanying weight gain. I'd say I'm blood sugar sensitive if I don't eat...but doesn't everyone get hangry once in awhile?

Any insights/experiences with metformin from people with "mild" PCOS--whether it's needed or not--would be very appreciated. Shady Grove didn't mention it at all, so I'm not sure if I'd have to push them to put me on it. Should I be doing additional testing with an endocrinologist? It seems like the treatment protocol (Clomid, IUIs, then IVF eventually) is pretty much the same regardless. Is it worth seeing if I have insulin resistance (and if I am, then should I consider metformin more?)? Should I get my testosterone (or anything else) tested to see if I have more PCOS symptoms? (And would that change anything if the proposed treatment is pretty much the same?)

Any other tips for navigating ART (IUI or IVF) from folks with similar profiles would be appreciated. So far this is really the only thing on my end.  We are just starting IUI. Everything else looks fine other than DH's morph is 3%. Gracias.

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