PCOS but getting regular periods with metformin

[nancy1984]

Hi, i thought i would reach out on here as my GP is being useless.
Ive had PCOS since my teens and have been taking metformin for 10 years. it's been great giving me regular periods, keeping weight down (size 10-12) and spots at bay (ish).
Why arent I able to conceive then? We are on our 4th month of trying! i know its early days but i just dont understsand

[AttilaTheMeerkat]

Its may be that you are not ovulating regularly if at all despite having periods. Its actually quite possible to also have periods without actually ovulating.

Will GP be willing to refer you now to a gynae at a subfertility unit bearing in mind the PCOS diagnosis you have also?. PCOS to my mind is an issue anyway well outside a GPs general remit and it more often than not needs specialist advice and help.

[AttilaTheMeerkat]

Also nancy if you are using OPK's would refrain from using them as of now. They are completely and utterly useless to use if PCOS is present. These kits work on two misleading principles that there is only one rise in LH every month and that such a rise is immediately followed by ovulation. Both are simply not true.

With PCOS as well the level of LH is often elevated so what the kit does is read that instead thus giving the user a false positive result or multiple positive results.

[nancy1984]

Hi thanks for your reply.
Yeh its so weird that i might be having periods without ovulating. It could be the case but i do get 2 lines on the ovulation kit and then a period 14 days later to the day. Surely this means ovulation?
im seeing him again next week so will ask for a referral.

[nancy1984]

Ok thank you - ive had my LH tested and apparently it is normal though.

[AttilaTheMeerkat]

No it does not mean that at all unfortunately, ovulation is not an exact science and ovulation can occur earlier, later or not at all in any given cycle. With PCOS non ovulation on a cycle is even more likely.

OPKs are useless and a waste of money to use as well when it comes to PCOS; infact I think the Clearblue kit advises not to use it at all if PCOS is an issue.

[AttilaTheMeerkat]

May I ask what your LH level was and was it compared to your FSH on day 2 or thereabouts?.

The Metformin certainly seems to be helping but it may not be quite enough.

Some PCOSers as well have had success with using both Metformin and clomid combined. However, if that happens you should be closely monitored with both blood tests and ultrasounds as clomid is quite powerful stuff and should be given with a degree of care to PCOS patients (clomid resistance is not unknown).

[nancy1984]

Ok thank you. So why would i get periods if no ovulation? PS: have you been through this?

[nancy1984]

Im collecting the tests next week but i called and they said all normal. What is FSH? oh thats another test. The tests werent carried out in relation to any time of the month. thats the next lot.

[AttilaTheMeerkat]

I was diagnosed with PCOS around 16 years ago now but my problems with it started at onset of menses.

Presumably the GP surgery has been arranging the blood tests.

These blood tests need to be done according to calendar days so for instance if you did not have a day 2 test done to check and compare your LH level against that of your FSH level the test result is meaningless. If periods are irregular then blood tests can be done according to calendar days.

What has your GP been doing with regards to blood tests?. Its not good whatever is happening and you should be referred. PCOS is also not a problem for GPs to be messing around with also in ignorance. Also another good reason for referral is you being on Metformin as well.

[naty1]

It can take a while for a healthy couple to get pregnant. So it is not necessarily something wrong.
Usually with pcos people will have irregular periods generally longer.
I think its a good sign the opk is picking ovulation up 14 days before period (although doesnt mean you have actually ovulated that can be measured on about 7 days after ovulation (usually cd21) in a progesterone test.
I would say just because you have a known issue doesnt mean its that or even anything causing you not to get pregnant.
Its worth getting a few tests done to see whats going on.
I would see if you can get a SA done (as pcos is almost irrelevant if there are sperm issues too)

[nancy1984]

Hi naty thanks for your reply. I'm worried by coming on these type of sites that it's making me more worked up. Yep we are having sperm test done so I guess I'll ask the doc nxt week what the next steps are! Inpatient xx