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Hydroxyurea, a cornerstone of sickle cell treatment, is considered a teratogen, so it comes off the table

Michigan, Rhode Island, and Wisconsin are planning or considering restrictions, according to KFFs most recent survey

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Second, improvements in IR and glycaemic indices are most apparent in higher-burden phenotypes, particularly in women with impaired glucose tolerance/prediabetes or related metabolic comorbidities, where changes in HOMA-IR, fasting glucose and OGTT profiles are more pronounced and may plausibly reduce periconception metabolic risk

Whether it delivers for your individual situation is something only you and your assigned clinical provider can determine