"Just try and forget about it, if nothing happens in a year come back"

[spottypyjamas]

Hello all,

Need to rant!

A little about me... Im 25, Been on the pill for 10 years, came off 9 months ago to let my body get back to normal. Been TTC only for a couple of months. My cycle has been all over the place the last few months i.e. 32 days to 49 days. Ive been doing OPK last few months, some months i'll get a positive, others i won't. Been temping for last couple of months, noticed a rise one month (but 7 days prior to my period) and nothing the next month.

Ive had a few trips to the GP to see whats going on. Blood tests showed abnormal FSH/LH ratio (despite Dr telling me i'm not overweight so i couldn't possibly have pcos). Had an ultrasound scan (external and internal). Got the results today, showing various cysts and diagnosing PCOS.

Dr said, try and relax, Dr said they couldn't prescribe anything in primary care to help and couldn't refer to gynae until i'd been trying for a year, but age is on my side. I should go away for a year and return if nothings happened.

Now i know i do have age on my side (and i understand lots of ladies are struggling who are much older than me so don't want to offend) but to say "try to relax and come back in a year" as if it was as easy as that! I'm one of those people who's always wanted children, and i've tried my best to get into a good situation before considering children (marraige, mortgage, good job etc) and i just feel so ready now. Just left feeling negative, and i know that stressing and sulking won't help the situation at all. ARRRRR!

Phew, that feels a bit better! Anyone had similar experiences, any tips ladies?

Thanks for listening xxx

[2ndDestiny]

Sorry you are having such a frustrating time

Your GP is wrong, as far as I know. You have a known fertility problem, which means the try-for-a-year-first rule does not apply, you are entitled to a referral to a fertility gynae straight away. (Unless things have very recently changed, hopefully someone else will come along and confirm).

Your GP also doesn't sound very clued up about PCOS. I have PCOS and have never been overweight. About 40% of PCOSers are in the 'lean' category.

I would go straight back and push for a referral. If no luck, you are entitled to see another GP.

The specialist will do further tests and go through various options with you. In the mean time, if you read up on PCOS (look at the verity website, and there are some very accessible, informative books by Colette Harris), there are some things you can do which may help a bit in the mean time. E.g. a low GI diet and regular can help to manage PCOS symptoms for some women.

Your cycles do sound very irregular but you may be ovulating some of the time. OPKs can sometimes give false results with PCOS (because we already have an imbalance of LH, which is the hormone they detect) so they may be misleading. Temping doesn't suit many women with PCOS but it works for me; you could persist and see if you find it helpful. It sounds like you might have ovulated one month but had quite a short luteal phase.

I have conceived more than once. My son was conceived when I was having very irregular cycles, I ovulated on cycle day 50 the month we made him. :) So it is possible.

[AttilaTheMeerkat]

Do not let this GP fob you off; PCOS is a bugger of a condition and often requires careful management. GP is also sadly misinformed re PCOS and stating that you cannot have this because you are not overweight is just plain ignorant.

I was a lean PCOSer on diagnosis just over a decade ago now.

See another GP and insist on them referring you now; it can take several months to receive an appt so making a referral request now is not unreasonable. You now have a PCOS dx so use that as leverage.

Would lay off both using OPKs and temp charting as both can be problematic for PCOSers (particularly OPKs because as 2nd Destiny rightly states, these measure LH and the kit measures the excess level of LH in PCOSers). You can also receive a rise in temp in the second half of the cycle when an egg has not been shed so charting is not totally infallible either. It is possible that you are ovulating occasionally but equally the reverse applies.

Would also suggest that you try and remain within the correct weight range for your height as excess pounds can exacerbate symptoms.

Do not be fobbed off, insist on them making that referral request now!.

[Elsathelion]

Argh OP I had the same thing - I was told that I couldn't have PCOS because I wasnt overweight, I had bloods and scans done privately for a diagnosis and my GP still wouldn't help me because I wasn't overweight and didn't have hirsuitism.

I insisted on seeing another GP who did help and got me in front of the right specialist.

As the others said, be persistent and don't be fobbed off. It is true that you can conceive naturally with PCOS but you are also entitled to help so you should be getting more support.

Sorry you are having such a frustrating time but hang in there! And good luck with TTC.

[eurochick]

There are a lot of slim PCOSers around - I'm one. Your GP is an idiot. Can you try to see someone else? Perhaps try to get a non-fertility related referral for the condition.

Whilst I understand your frustration, I don't think the try for a year thing is a bad idea though. The investigations and treatments are not terribly pleasant. If you are ovulating at least some of the time (many PCOSers do, including me) you might well get pregnant without treatment. I am putting myself through them because I am 36 now and have been trying for 19 cycles, and feel like I am running out of time. If I were younger I would definitely prefer to try for longer before having invasive treatments.

[2ndDestiny]

Hi again spotty

I agree with eurochick about being cautious about invasive treatment, but I would still demand a referral straight away because as Attila says, it can take weeks just to get the appointment. You can be trying naturally in the mean time.

Also, the first line of treatment is unlikely to be invasive, and IME fertility specialists don't hand out treatment that they don't think is necessary. The Gynae I saw took a very thorough history, looked at two sets of blood results, and advised me that she thought I would conceive naturally and to keep trying with review appointments every 3 months. It really helped to see her though because I had a lot of questions and she helped me to understand what was going on with my awkward ovaries.

After 4 months when ovulation went awol again, I managed to get the Gynae on the phone who prescribed chlomid. A day or two later, while waiting to collect the prescription, I ovulated and conceived my DS. I was on Metformin (prescribed privately), but in hindsight I think I would have conceived without it

Hope this helps and good luck

[minipie]

From what I have read, the main fertility issues caused by PCOS are either that you are not ovulating at all, or you are ovulating but you don't know when so can't time sex right.

So, the most important question is - did your blood tests show you were ovulating? You need to have your progesterone tested 7 days after estimated ovulation/7 days before your period, and you need a high result to show ovulation.

If your blood tests showed you are not ovulating then there is an obvious next step, which is Clomid to induce ovulation.

If your blood tests show you are ovulating then there is not much more the doctors can do AFAIK - it's really a question of getting the timing right. Doctors will just advise "have sex every other day throughout the month" and tbh it is worth trying that for a few months to ensure it's not a timing issue.

There is also another potential issue from PCOS, which is that if you have very long cycles and ovulate late, the egg may not be of good enough quality to get fertilised or implant. Again, there is not much doctors can do about this AFAIK, but some women find acupuncture helps shorten/regulate cycles.

In my (limited) experience, PCOS does not necessarily cause a major barrier to conceiving. I have a friend with PCOS who has fallen pg twice within the first month of trying. I have PCOS and hypothyroid, and fell pg as soon as the hypothyroid was fixed, suggesting the PCOS was not the issue. It will of course be a major barrier if you are not ovulating - so that's why it's important that you are tested for ovulation.

Best of luck. I do understand your impatience.

[spottypyjamas]

Thank you so much everyone for your responses, really appreciate it.

I know i haven't been trying for long but you have all boosted my confidence in retuning and requesting a referral to gynae. I am considering a comprimise however and waiting 3 months, in this time i want to try (don't know how!)
to bd every 2-3 days throughout the cycle and ignore all these random temp OPK results.

In regards to tests minipie my blood test was a week after my period (unsure why i was told this time?) this showed the LSH/FH ratio was abnormal. I have not have the blood test to show progesterone levels, which as you say determines the problem therefore potential treatement options. I will request this also.

Attila, i agree that i should put the thermometer and OPK away, it's just driving me crackers and not showing me anything helpful (other than that things aren't right)

2nddestiny i will look at the websites suggested, and try to learn as much as i can, so that when i do return to the GP i am armed with the correct info (as it doesn't appear i can rely on them for that!)

Eurochick thanks for your view also, its good to hear all different opinions. You are right about the unpleasant tests, i've only had the ultrasound and almost wee'd myself in the waiting room, was soooo desperate to go!

Thanks again everyone, i'll keep you informed x

[minipie]

Yes, do request the progesterone test to see if you are ovulating.

It's often called the "day 21 test" but this is misleading as it's only on day 21 if you have 28 day cycles. It's meant to be done 7 days after ovulation or 7 days before your period. It can be a bit tricky to time it if your cycles are irregular and OPKs don't work, but aim for your best guess!

Personally I wouldn't be too pushy for a gynae referral just yet as I don't think you'll get anywhere based just on PCOS - I'd press for the progesterone test and then if that shows no ovulation, definitely press for a referral so you can get Clomid.