PCOS: but I think I am ovulating?

[minciepie]

Hi everyone

So, I've just been diagnosed (by scan) with PCOS . I haven't seen the GP to discuss this yet as I have to wait to have blood tests too. We've been ttc for 6 months.

The thing is, I am getting periods (long cycles 32-40 days but fairly regular) and I use OPKs and get a positive result every month, always 14 days before AF. So that seems to say I am ovulating? Or is it possible to get a +ve OPK without ovulating?

I guess I am wondering what treatment there might be for PCOS that would help me get pg. Clomid seems to be the usual, but if I am already ovulating then Clomid won't help I presume ...?

Any thoughts or experience would be very much appreciated... Thanks.

that's what worries me about charting, I could easily get a bit obsessive about it!

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.

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!

Far of course - done

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

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!

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.

Interesting rose. Receptionist definitely said PCOS, she said it meant nothing to her she was just reading the scan results - though thinking about it I don't see how just a scan could diagnose PCOS rather than PCO, so maybe the scan person is confusing the two.

But I am lined up to have the blood tests too (just waiting for the right cycle days) so guess I'll see about the hormones etc then.

I suspect I do have dodgy hormones too though given the state of my skin .

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?

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.

Thanks euro! I do mostly eat low GI but could do better on that. I have also considered going to an acupuncturist so interesting to hear that seems to be helping you.

Also helpful to hear of more people who OPKs do work for... your situation sounds like mine, fairly regular cycles albeit a bit of variety in length, LH surge 2 weeks before AF.

Can I ask what tests it was that showed you were ovulating? Was it the hormone blood tests that you got to diagnose PCOS, or some other specific tests?

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.

Right, will keep peeing on those sticks then and use those to work out when to go for the 7dpo tests - might be wrong but it's the best indicator I have at the moment. My cycles are long though - 32-40 days - so it's going to be more like day 30 for me than day 21.

Glad to hear that should indicate ovulation or not.

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.

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!

underbeneathiInteresting what you say about waiting till 2 days post positive OPK. I reckon that 2 days post positive OPK is when we have generally stopped SWI'ing in previous months. This is because I thought SWI had to be around the time of positive OPK to have any chance of success - I thought 2 days after would be too late?

So if I am wrong about that, maybe it's all down to stupid timing on our part! [doh] Will definitely keep going for longer this month and see if that helps!

Yep DH is lined up to have a semen analysis - probably about the same time I have my blood tests. I have read that if your DP have low sperm count it's better to hold back till the right time (rather than SWI lots) so sounds like that worked for you. Otherwise, I have read it's best to just SWI as much as poss...

mrsden I do ovulate late - day 26 last month was the positive OPK so I guess day 28 actual ovulation! So does that mean that even if I get pg, I am more likely to then lose the pg or have something wrong with it, due to having crappy eggs?

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

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 :)

Right, so the reason I'm not pregnant is probably nothing to do with PCOS and mostly to do with stopping dtd too early each month

mind you if that is it, at least it's easily fixed

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