PCOS - Ovarian Drilling - IVF

[vallinnapod]

Hey ladies,

Just interested in opinions out there...quick biog!

29, average BMI, no excessive hair, TTC for 7 months. Came off the pill after 11 years. No period. Hormone tests normal. Pelvic ultrasound shows polycystic ovaries.

Clomid recommended. Went private (not important, just explaining time scales). 50mg cycle clomid given. Regular pelvic ultrasounds. Did nothing. 21 day blood test showed nothing! Had a really bad experience with lack of contact with my consultant so change clinics.

GP prescribes Metformin (500mg 3 times a day)

Next clinic...course of northisterone to induce a bleed then a course of 5mg Letrozole. Scans etc...nothing.

Have an appointment to see my consultant on 12th October where, according to my nurse it is likley that ovarian drilling or IVF will be recommended.

Any ovarian drilling experiences out there? I my mind, after the cost, wait and possibility it my not work, is it possibly better to go straight to IVF?

Interested to hear from people in a similar position.

Thanks!

I am currently recovering from a laparoscopy with ovarian drilling. Have been ttc for 3 1/2 years now and in that time have been given both clomid and gonal f injections for ovulation induction- neither worked.

As with yourself consultant said to give the drilling a chance and then move onto IVF if that does not work. The waiting list for IVF is currently 16 months where I am so am really hoping that the ovarian drilling works. The theory is that for people with polycystic ovaries that the drilling allows for some return to "normal" ovulatory cycles for a limited time- it is not a cure but may make ovulation possible for up to about 8 months but that is probably the best case scenario.

Anyway the lap did not hurt and in my opinion it is worth having if they are offering it. I wish I had been offered it years ago as they found my left ovary was stuck to my bowel and thankfully were able to fix this while in there.

The person you really want to reply to this is a mumsnet expert on pcos: atillathemeerkat is her username if you do a search- if I recall she became pregnant after having ovarian drilling.

Sorry for rambling - if you want to know any specifics just ask. Good luck!

Thanks for your response. I hadn't realised it was only a temporary solution. I think I will see if I can push to go straight for IVF. As we are doing this privately it is getting very expensive already. I think I would rather bite the cost/emotionally bullet and go for IVF.

Wish I had just got on with it at 16 like the rest of my class ;)

vallinnapod

I have PCOS and had the operation you describe (its proper name is laparoscopic ovarian diathermy). Ovarian drilling is not really what happens here in this surgery; the cystic follicles on the ovaries are popped using an electrical laser or needle. As it is quite a demanding procedure (it has a steep learnign curve) it is really best done by a gynae surgeon who has had a lot of experience in doing such a procudure. I would ask the surgeon directly how much experience he has had in doing this type of surgery and if the reply is not much then find another surgeon. I am a parent directly as a result of diathermy surgery and equally I do know of cases where it has worked with resultant pg and has not worked.

IVF certainly has its place but there are risks associated with this procedure as well with regards to PCO. You need to be aware of this. Overstimulation of the ovaries due to the drugs given can happen and it is vitally important that you are closely monitored at every stage. It may be that they will suggest you try surgery first; IVF is usually suggested when all other treatment options have failed.

any other questions just ask.

Thanks for taking your time to share your story. One thing I am learning from this whole experience is that I need to be armed to the teeth with all possible information and this is great.

Hi

I had ovarian drilling and fell pregnant the next month. They also will probably do a dye test to see if you have tube problems at the same time. Metformin is used to bring your insulin levels back to normal, which then means ovulation restarts in some women, but of your BMI is normal the insulin levels are probably not the problem so it's not surprising that it did nothing for you.

Could you do another round of clomid whilst actually being monitored properly so they can see if the follicles are developing as expected? I can understand that you are impatient but IVF is really an intrusive procedure.

I have to go and put son to bed will return later with more, if you have any questions please ask!

oh and some things to think about,

if ovarian drilling works it may only be temp but then you have 10 attempts or so whilst you ovulate. IVF is not guaranteed to work and the success rates vary wildly.

Your consulatant may well reccomend either procedure, an operation or IVF earns him far more money than other less invasive options that you haven't explored yet.

PCOS is a hormone imbalance, and something is causing that imbalance, mostly it is insulin but it can be caused by a range of things, you need to look further into these after 7 months IMO. That is the reason that the ovarian drilling is only temporary, you havn't found the root of the problem so it will return. The important thing to remember is that once you have found the imbalance it can sort itself out very quickly, which is why metformin is so sucessful for some women.

Thanks Row. Had a HyCoSy and all fine. So many options (which is a good thing!!)