PCOS: but I think I am ovulating?

Re dtd we just did it every other day till period or bfp. Not romantic but certainly humourous especially when I had legs stuck up in air to aid the little swimmers sense of direction lol

Mincepie generally you get a +OPK 12-36 hours before you ovulate, so you want to be dtd for a few days before and a few days after :)

I have PCOS, conceived ds1 unplanned. Ds2 Clomid appeared to have not worked then found out preg. Dd took over 2 years no fertility in the end as still bfing. Weight has alot to do with it and dh and I has sex at least 3x a week. Monitoring cm gave best indicator for me

Hello,

I was told I had PCOS following a scan and also a blood test which showed my LH and FSH were out of balance. However, I have been told that the blood tests can be normal even if you still have PCOS. I think they usually diagnose it if you have poly cystic ovaries plus one of the other symptoms or out of balance hormones and pc ovaries (as in my case). My periods are regular and my cycles are around 30 days with ovulation between days 14 and 17. I temp and I know that I ovulate most months (2 cycles out of 12 have been anovulatory which I don't think is unusual even for women without pcos) so it is very possible that you are ovulating ok. The only thing to be wary of is the later you ovulate the more likely it is that the egg is of poor quality. This is one of the reasons clomid is used even when women ovulate because it causes earlier ovulation and can improve egg quality.

Good luck!

I have PCOS - acne - and we were TTCing for three years. In the end I realised that temping was too stressful and just used the weestix. I only ever got one positive per cycle.

We got preggo when we absolutely waited until all the EWCM had gone, as were were exhausting ourselves when it was there. So we ttc'd when I was 2d post ovluation as per stix, and all EWCM gone.

Has your DP/H had a semen analysis - my DH's sperm were poor quality, which added considerably to the infertility mix. It may be a factor for you too. I had him on multivits and zinc for months after his results, and he had a strong coffee before we did the deed!

Best of luck.

We do sound similar. My cycles used to range from 3-6 weeks when I was younger but over the past couple of years have stayed within the 25-33 day range. I have a friend with PCOS who never has periods at all (she's currently undergoing IVF), so there is definitely a spectrum of severity.

I had Day 3 tests which looked at LH and FSH levels (among other things). These can be an indicator for PCOS because as Atilla mentioned, LH is often elevated in PCOS women. They also look at androgen and testosterone levels for PCOS as it is the male hormones that cause the acne and hair growth.

The Day 21 (or 7 days post ovulation) test is the one that is usually used to see whether you are ovulating. It tests progesterone. Most gynaes seem to say it needs to be over 30 to confirm ovulation (although I have seen on these boards others say that 25 is fine and some gynaes wanting to see higher numbers). Mine was bang on 30 but at 6 rather than 7dpo (due to the blood clinic closing at weekends) and I've had two gynaes now both look at the results and be happy that I am ovulating.

The day 3 and 21 blood tests are usually the first port of call for most drs when they see patients complaining of fertility problems. My GP ran them and then referred me to a gynae.

minciepie I would recommend a book called The PCOS handbook (by Colette Harris and Theresa Cheung) if you want to learn more about the condition. I was diagnosed with PCOS when I was 17, 18 years ago when a lot less was understood about the condition. I learned a lot from that book when a friend who was diagnosed much more recently recommended it to me when I looked confused when she mentioned low GI.

I am slimmish (BMI 21), have monthly periods (although they do vary in length) and have some excess hair. I don't have acne but I do get a few more spots than the average 35 yr old. My hormones were all normal when tested a few months ago at the beginning of fertility investigations. I used to suffer a lot with insulin resistence (I'd feel sick and dizzy if my blood sugar dropped) but keeping my blood sugar more stable by eating a lowish GI diet has helped that.

My PCOS now seems to be under control. I try to eat low GI food most of the time and have also been having fertility acupuncture to try to balance my hormones. My latest scan showed my ovaries to be multicycstic rather than polysystic (i.e. there were more follicles present than would be expected on a "normal" ovary but not the string of pearls look typical of a polycycstic ovary) so something seems to be helping. Tests show I ovulate.

Like you and poppyjen, I find that OPKs and temping does work for me. I think if you have no cycle at all or very occasional periods it will be difficult to use OPKs effectively or see a temp pattern developing but I get one clear LH surge when I use OPKs, always around 2 weeks before my period and if I temp I get a very clear biphasic pattern (i.e. roughly two weeks of low temps followed by 2 weeks of high temps) so both indicators are doing what they should for an ovulatory cycle. Incidentally, my gynae who specialises in PCOS recommends women use OPKs when he is using fertility treatments and trying to track ov. If you get a single LH surge indicating ov 14 days before your period it certainly seems like they are working for you.

I have the acne too and the facial hair (nice!) but without anything showing up on the blood tests.

Apparently PCOS can make you more sensitive to hormones and your body overeacts to them. My PCOS was also diagnosed via scan.

I am trying a low GI diet, B vitamins (apparently us PCOS are sometimes defficient in this) and I also ordering this : Chiral Balance D-chiro-inositol
which seems to be a very popular supplement in the States for dealing with insulin resistance naturally. Has anyone tried it?

Like some others have said, make sure that you have PCOS and not simply polycystic ovaries.

I came off the pill in December 2008, and didn't get a period for 6m. During that time I saw a consultant who scanned me and told me I had polycystic ovaries and immediately prescribed Metformin. No bloods, nothing. I went along with this, and took the Metformin which did nothing at all other than make me feel sick. After 6m, I started ovulating naturally and fell pregnant on our first attempt three months later. I've since had multiple scans for various reasons and although I clearly have polycystic ovaries, I do NOT have PCOS - my hormones are totally fine. The consultant was talking rubbish and prescribing me drugs unnecessarily.

Polycystic ovaries are not in themselves a fertility problem. It is only when they occur together with hormonal issues that they can affect fertility (and it's then that you should listen to all the excellent advice given by others).

So many people confuse the two (like potentially your GP's receptionist), but you can have PCO without having PCOS and you need to make sure which category you fall into.

Hi 1sttime I don't mind at all - it was £175 for an hour's consultation. Any tests etc were extra but as I already had a diagnosis and took along a copy of my notes to that effect I didn't have to have any more. It was definitely worth the money if nothing else it was great to talk to a specialist

Good luck!

Hi poppy do you mind me asking how much it cost you to see the cosultant etc. I have bee diagnosed with pcos and all the doctors are telling me is that its not a problem so dont worry and just try and lose some weight, they are not willing to help me at all. I was having very irregular periods 42,48, 70 day cycles and now nothing for nearly 5 months, getting really fustrated about it all and have considered paying to see a consultant to try and get some more help. Thanks

Far of course - done

Just a quick note about the blood tests as well. I have read research that the LH imbalance is only picked up in 50% of people with PCOS and that was the case with me.

My LH and FSH were perfectly in balance but a scan revealed PCOS and I not suprised because I have developed terrible acne since coming off the pill!

I also ovulate every month and like Poppy have had an early miscarriage and a chemical so I do wonder if the hormone inbalance is causing issues further done the line. I am going to try the low GI approach as well. POPPY please can you PM me your consultant's details, he really sounds like he knows what he is talking about!

mincie,

If you feel that you're going to get obsessed about it, don't do it or if you do stick to a strict time limit of say 3 months and no longer. It could just cause your more stress to an already stressful situation, certainly stop if you start to stress out over taking the temp every day.

You'd be better off having regular blood tests and ultrasounds. It would be interesting to see if the results of the bloods correspond with the temp chart or whether the temp chart goes onto mislead. I know what results I would trust more.

PCOS requires careful management in any event.

I have PCOS and the causes of PCOS are not fully understood. There is evidence of such imbalances being passed down the generations on the male side (male pattern baldness for instance) so the male side has been implicated. Not every women with PCOS is IR by any means. It is truly a very individualistic disorder and does affect each woman with it very differently. Temp charting and the like would have unfortunately served me no purpose at all with my practically non existant cycle!. I would assume nothing is happening re ovulation every month unless it is confirmed otherwise by the hospital. DO not forget either that the cystic follicles associated with PCOS do disappear only to be replaced by other cystic follicles.

he was great, I can highly recommend him. If anyone wants to know details of the clinic PM me.

It was so refreshing to talk to him after months and months of GPs telling me that I just had to wait it out and in the meantime to lose weight (I am 52 kg at 5'1 so not great advice really )

Anyway, good luck - I hope you get on with charting, I found it fascinating. Fertility friend is really good.

minciepie as I said OPKs and temping worked for me - and I know that I have been ovulating (miscarriage and 2 chemicals back this up too). I know that nothing can be 100% certain (apart from a pregnancy of course) but if you have found that you have had positive OPKs, and then AF around 2 weeks later in the past I would suggest that you try temping and see whether the temp rise and the OPKs tally up.

Temping is reliable as long as you remember to take your temp at the same time each day and before you do anything else (even talk). So keep the thermometer next to your bed and set an alarm. OPKs are reliable too - the main concern with women with PCOS using them is that you may get several positive results. I have never had this and sounds like you haven't either. I would say that even if you did only one of the positive results would tie up with the temp rise so that way you would cover your bases if you see what I mean.

The reason that health care professionals don't think temping is reliable is not because it doesn't work, it is that they don't trust us laypeople to be able to do it with sufficient accuracy (i.e. to do it at the same time every day to make it true basal body temperature). The fact is that it does work, it is as reliable as you can get without constant scans and blood tests and is an easy way for you to feel like you know what is going on

My consultant's specialist area is PCOS, and he has written extensively on the subject and lectures on it. He was an absolute mine of information. He said that a lot of interesting new research was coming through about PCOS and basically disproving some of the earlier research regarding LH levels completely - which means that the old advice regarding the unreliability of OPKs for PCOS women is not true.

He also said that there are some interesting early results suggesting that PCOS is always linked to insulin levels and that cystic ovaries are only one symptom that MAY be present and that it is possible that even men could have it (not cystic ovaries obviously but the same hormone imbalance caused by insulin resistance). This is backed up by the fact that women who have no cysts on their ovaries can have PCOS, and women who have lots of cysts may not have it.

I would say give temping and OPKs a try, you have nothing to lose

I wonder if it might be that the pill "corrects" the hormone imbalance that we get with PCOS, so actually makes you more likely to conceive while the pill chemicals are still in your system?

No, if anything the pill masks the symptoms of the underlying hormonal problem that has always been there. Also the causes of PCOS are still not fully understood.

PCOS is a very individualistic disorder and affects each woman with it very differently. The commonality though is the cystic follicles on the ovaries. These do disappear - only to be replaced by further cystic follicles. Some of these follicles pump out hormones further disrupting ovulation (that is also why OPKs are of no real use in women with PCOS), some are dormant and others may contain an egg. Some women with PCOS do ovulate occasionally and spontaneously as well BUT most will need some more help in order to conceive.

If your Day 2 test shows the LH/FSH imbalance (i.e excess LH level compared to that of FSH) then it is likely that your Day 21 will also show no ovulation as well. In my particular case my sky high LH level put me at greater risk of miscarrying. LH and FSH are two very important hormones as they kickstart the ovulation process.

Would not place too much emphasis on temp charting particularly if you end up with a very difficult to interpret chart. Many gynaes as well do not take much notice of such charts primarily because they can be unreliable. I would go by the ultrasounds and blood test results rather than a single positive OPK result as these are far more accurate. Also using OPKs every day can cause you yet more stress in an already difficult situation,

Not every women with PCOS is actually insulin resistant (yet another conumdrum) so you may or may not be prescribed Metformin by a consultant gynae or be given a met/clomid combination (this can work well for PCOSers rather than just clomid solely).

If your periods are really irregular as well, the tests can be done according to calendar days (i.e the 2nd and around the 21st of the month). These tests should be repeated and you should have regular internal ultrasounds to further assess the state of your ovaries and uterine cavity (lining can be very thin in PCOSers).

HSG test is a tubal x-ray. It is a useful test to have done as it can give information not usually accessible by other methods. Deformities INSIDE the tube can only be seen on a HSG. It should not hurt providing the dye is injected both slowly and carefully. The staff should give you a couple of painkillers beforehand. If you have a HSG sanitary protection should be used post proceudre as that dye (only about a teaspoonful is used) comes out!.

If you are not already under the care of a gynae at a subfertility unit you should be. Some GPs are pretty much hopeless when it comes to PCOS and many such cases require careful management.

Try and remain within the correct weight range for your height; PCOS symptoms can be worsened by excess pounds. Many women find a low GI/GL eating plan helpful as this is more sustainable to do longer term than say low carb.