PCOS and Gynae Appointment - Long

[ALovelyBunchOfBaubles]

Hi there to anyone who can offer me some advice. I have posted many times here before and Attilathemeerkat had always given me great advice. After 5 years of rubbish history including miscarriages and an ERPC, I finally have a diagnosis of PCOS. I have my first gynae appointment early January after pushing and pushing my rubbish GP to refer due to no period for 6 months.

I have written down my history and a list of questions to ask when I go and I would love to know if anyone could advise me of anything I have missed or have written unclearly from an objective POV.

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? Diagnosed with PCOS on 9th November. Internal scan. Also trying to conceive. Period absent for 6 months and started on 6th December.

History

? Pregnant at 18 in 2005, miscarriage at approx 12 weeks (LMP 8/10/05... mc on 31/12/05)
? October/November 2006 diagnosed with PID, treated with AB?s
? Still suffering symptoms Jan 2007
? Referred to gynae
? Laparoscopy offered, suspected endometriosis
? Fell pregnant March 2007
? Missed Micarriage at 10 weeks, foetus measuring 7 weeks.
? ERPC April 2007
? Fell pregnant June 2007.
? Had baby 10th April 2008, she is now almost three.
? Laparoscopy never done as was pregnant when the appointment came through.
? On Cilest after giving birth until February 2010, when started trying to conceive
? Periods this year ? 8th to 14th May and 19th to 24th June
? See GP for routine bloods August 2010, all normal (I have the copy of these)
? More bloods October 2010, all normal
? Sexual health screening done also in October, all clear
? Scan 9th Novemeber, reveals PCOS
? Follow up GP appointment 2 weeks later, referred here.
? I also have a bi-cornuate uterus
? For the last year my skin has worsened, and my legs and breasts are becoming hairier than before.
? Always tired and low.

Questions

? Definitely PCOS? Based on my history do you think anything else is apparent?
? Would the laparoscopy offered 3 years ago be a good idea?
? Has the Bi-cornuate uterus had any bearing on my problems to date? How separated is my uterus? Diagram?
? Do any more bloods/scans need to be done? Do these need to be done at a perticular time in my cycle? Almost impossible due to the irregulartity of my periods.
? What treatment would you recommend for my PCOS?
? How long would any treatment continue bofore a review?
? Would any treatment be offered to help with conception? Metformin? Clomid?

And the question marks were meant to be bullet points. How strange. My pc seems to have changed them. And I hit post too soon.

Thanks in advance for any replies :)

Bump

Hi sunny we miss you over on the buns thread. You should pop in and tell us how things are going :) When you were last on there didn't you get a BFP? There have been some more since you disappeared :)

When we last spoke I hadn't been diagnosed yet, it was still chasing doctors to take me seriously. As you can see from my history it's taken 5 years to get this far.

I have had a thyroid test although I don't know the figure. I asked my GP for a pring out of all my bloods that were done but for some reason she didn't include them all and said if I want any more copied that I'll have to pay. Does the thyroid have to be done on a particular cycle day?

I have no idea on my ov, because I started using OPKs and then found out they were hugely unreliable with PCOS, stopped using them a few weeks later AF came. So no period from June to December but it started 6th December and it's still going strong.

Thanks for your reply xx

Hi alovelybunch,

Thanks for the kind compliment:).

You ask some good questions in your list.

I would ask them how often you will be seen and will you be seen by the same people each time?. Continuity of care is vitally important.

If clomid is offered you should be monitored monthly whilst on it. If they do not give you monitoring stand your ground on that issue. Monitoring is essential as clomid is quite powerful stuff and no monitoring also means you have no idea of whether its doing the job its supposed to be doing.

I would also ask whether ovarian diathermy surgery can be considered for yourself. This has some success with PCOS patients as it can lower LH levels and thus kickstart ovulation. It is not a cure for PCOS and no one therapy or treatment will completely eradicate it but it may help.

BTW blood tests can be done according to calendar days. I used to get mine done on the 3rd, 10th and 21st of each month (they were repeated monthly to see if there were any marked changes to my imbalanced LH/FSH levels (there were not).

You need up to date test results; anything done over 6 months ago should now be discounted.

Thanks for the replies sunny and attila

I have added some new questions to my list based on your responses.

I have queried Thyroid, suggested repeated calendar day tests over the course of a couple of months. I have asked what their monitoring procedure is if Clomid is offered, how often I will be seen and whether it will always be the same doctor and also whether the ovarian drilling is a viable / necessary option for me.

My appointment is on 5th January so I will report back to you :)

I now feel that my list is quite comprehensive and at least shows that I understand quite a bit about the treatments that are available so hopefully they will take me seriously and answer me honestly.

Thanks once again, much appreciated :)

Good luck on the 5th January.

Do keep us posted.

Good luck... I have been told I may have some form of PCOS, on spectrum etc... recommended losing weight would help, more healthy foods etc.

Hi Keziah, sorry to hear you may be suffering too. Really push for a diagnosis either way. I am lucky in that I'm not overly overweight although I am trying to eat a bit healthier and do more exercise as I'm told it helps.

Alovelybunch - no, I didn't think I was really overweight either (BMI was 31, got it down to about 28 now), but apparently it helps... we need ICSI due to male factors so apparently there is no need to do anything about mine as will need to go straight to ICSI. Hope your appointment goes well, not long now!

Keziah, My BMI is 24 so I'm pretty much "normal" although I would like to lose a few pounds, but who doesn't hey!

Of all the people I've spoken to regarding PCOS it isn't the only factor relating to the fertility problems. Why can't we just have one thing and treat it and crack on! It's so unfortunate that your DH has problems too and PCOS also can come with Endometriosis (which I may have).

If only there was a gynaecologist on MN [hopeful]

Maybe there is!

24 is great - my goal too! Interesting PCOS isn't the only factor for so many - it was only recently picked up for me, hence I am now having a concerted effort at getting BMI to 24-5, to see if it helps (oh what a good time of year for that!), etc. Ouch for Endometriosis... is your bi-cornuate (sp) uterus a problem also? Hopefully your apt will give you more answers x

I was always told that a bi-cornuate uterus would cause no problems what so ever but I have since found out it can cause a higher miscarriage risk if the egg implants on the wrong side. Hopefully at the appointment they offer a laparoscopy of somethng so the insides of me can actually be seen :)

And same for me Keziah, only diagnosed a month ago.