Hi quick question. For those who use metformin for managing PCOS, do you stop

Not automatically solely because pregnancy has been confirmed. Metformin can be considered during pregnancy if clinically needed, but this does not establish a reason to continue it specifically for PCOS SmPC Metformin.

Review the ongoing indication with the prescribing specialist. Metformin use for PCOS is off-label, and NICE CKS advises reconsidering its ongoing requirement; the supplied PCOS guidance does not specify when to stop it after conception NICE CKS.

• If prescribed only for PCOS: agree an individualised continuation or discontinuation plan rather than assuming it must continue throughout pregnancy, given the uncertainty about its benefits in PCOS and the need to review ongoing treatment NICE CKS.
• If there is also diabetes or clinically significant hyperglycaemia: the decision must preserve adequate glycaemic control, as uncontrolled hyperglycaemia increases adverse pregnancy outcomes; metformin may be considered as an addition or alternative to insulin when clinically needed SmPC Metformin.
• Reassure about exposure so far: available pregnancy data indicate no increased risk of congenital abnormalities or fetal/neonatal toxicity, although metformin crosses the placenta and long-term offspring outcome data remain limited SmPC Metformin.

The supplied product information differs: one SmPC recommends insulin instead during pregnancy, whereas the Tillomed SmPC permits metformin when clinically needed, so check the actual preparation’s prescribing information when reviewing treatment SmPC METFORMIN,SmPC Metformin.