PCOS and ttc!

[KylieP]

Someone just suggested setting up a PCOS and ttc thread - I'm on the June ttc thread but would love to hear from other PCOS'ers too!

[Jodidi]

I suppose I'm technically on the 2ww Tremolo. We've only dtd once this month though and I'm not even convinced I ov'd. Fertility Friend seems to think I did but when I look at my chart all I see is a bit of a temp spike before it came back down to normal. I'm now 8dpo according to FF and feeling very crampy (although that might be wind ) and rather weepy (might still be because of the mc and thoughtless comments made this week)

[Jodidi]

I think different people work different ways. Are you temping at all? I find I can just about tell now (after temping for 2 years when ttc before and a couple of months now) when I ov, but my cycles are not regular so can't tell by dates. I take my temperature as soon as I wake up (between 6 and 7 for me), before I do anything else, then type that temperature into Fertility Friend which plots a graph and can tell you when you ov. There are other signs to look out for too, such as cervical mucous etc. I also got one of these which you can look at your saliva in the morning and the patterns it makes changes when you are ovulating. It's wierd but it seemed to work.

[Jodidi]

I know what you mean about wanting to be relaxed about it to start with. When I first started ttc with dd2 I assumed it would be easy (I didn't know about pcos then and dd1 had been an accident) so just thought we would stop the contraception and it would just happen (how naive was I?!). I didn't have a single period in the first year of ttc then had one and took another 5 months before I had another. It was at that point I was diagnosed with the pcos and I started taking care of my diet, exercise, vitamins, etc and my cycles became slightly more regular.

I think I wish I'd known at the start what I knew by the end, as I would have missed the 18 months where nothing happened but there was nothing I could do about it because I didn't know why I wasn't having periods but just knew it was quite normal for me.

[TremoloGreen]

Well, fingers crossed Jodidi - I'm sorry for your loss. I also wish I had known about PCOS sooner, I'm slightly embarrassed that I spent 10 years on the pill, knowing I had irregular cycles but just ignoring the issue. I have stopped getting excited during the 2 week wait really, but I tend to feel pretty miserable when my period comes.

Freesea, if you have a six week cycle, it is likely you ovulate around the 4 week mark. Variability in cycles is due to time taken to ovulate, once you ovulate, it is pretty much a given that a period will occur, and this varies less for each individual. For most women it is 10-14 days after ovulation. If it is shorter, it might be a problem for a fertilised egg to implant. If/when you do start temping, you'll be able to monitor this.

I also ovulate late, then have a short luteal (post-ov) phase. I think it's because the follicle is poor quality so doesn't produce enough progesterone. I'm planning to try Clomid later in the year, hopefully if it brings ovulation forward, it will also lengthen the LP. In the mean time, I'm trying every lifestyle measure possible to try and regulate ovulation

[RIBS]

free I know opk's arent supposed to be any good when you've got pcos but they work for me. That and temping. Just to confuse things. I have a 18 day LP. From positive ov stick and temp spike. Wierd or what!

Im defo on the 2ww but still at it eod for the next week regardless. Im not taking any chances. I know im going to be fairly regular with the clomid so stopped temping and OPKing. EWCM left yesterday, but we've stopped dtd previously when its gone so thought id keep at it another wk and see what happens. so playing the waiting game now. Ho Hum, tick tock!!

[mrsmellow]

Hi ladies,
I've been avoiding threads out of some kind of misplaced superstition (because posting on the internet can affect your fertility ) and because I think posting previously has been associated with optimism and then being disappointed. But I have PCOS - diagnosed on scan in February after 7 months of TTC with irregular periods. I am the lean type too, and vaguely started a low GI diet a few weeks ago, always exercise plenty ( but currently have a coffee and biscuit in hand ). Will give up caffeine tomorrow
I'm on my first cycle of Clomid - day 15, just had a scan and have a dominant follicle (yay! ) but thin uterine lining (boo ) so will probably ovulate in the next day or two according to my Dr so will be having plenty of sex this week, then in enter a symptom spotting frenzied 2ww... am booked for a day 21 progesterone blood test next week to confirm ovulation - am quite pleased with my Dr., she's great! If I'm unsuccessful this cycle, she's suggesting trying something else as the thin uterine lining is a known side effect of clomid... so after this week of sex, will have everything crossed especially fingers

Actually RIBS I might take a leaf out of your book and keep up the EOD sex for an extra week, just in case!

[AttilaTheMeerkat]

"if you have a six week cycle, it is likely you ovulate around the 4 week mark. Variability in cycles is due to time taken to ovulate, once you ovulate, it is pretty much a given that a period will occur, and this varies less for each individual. For most women it is 10-14 days after ovulation".

Unfortunately the above is not so.

A "normal" cycle is a cycle length of between 21 and 35 days OR with less than 4 days of variation from month to month.

If the menstrual cycle is consistently around the six week mark then ovulation is likely not to be happening regularly, if at all. It is also possible to have periods without actually ovulating. It is also not correct to assume that ovulation occurs around two weeks after the start of the last period, ovulation is not an exact science and it can occur earlier, later or not at all in ANY given cycle. Even normally fertile women have the occasional anovulatory cycle; with PCOS anopvulatory cycles are far more likely to occur more often even though PCOSers (I was diagnosed with PCOS around a decade or so ago) can have the occasional ovulatory cycle.

[TremoloGreen]

Yes, sorry, it is also possible that a six-week cycle is anovulatory.I don't know if you can say this is 'more likely' or not. The only way to know is with trying methods to chart ovulation, although you should be aware that these may not work for you if you have PCOS.

I have PCOS. I definitely ovulate. Between CD26 and 28 for the last six months. Before that, I wasn't charting or having tests. Many women with PCOS do ovulate. Whether late or irregular ovulation results in a healthy pregnancy is a separate issue, obviously.

[AttilaTheMeerkat]

Hi tremelo

re this part of your comment:-
"Many women with PCOS do ovulate. Whether late or irregular ovulation results in a healthy pregnancy is a separate issue, obviously"

True re the first sentence (even I ovulated once or twice she writes in amazement) but usually it is only occasional and in my case tests showed non ovulation more often than ovulation.

There is evidence to suggest that very high LH levels can be implicated in miscarriage. I was told by my cons at the time that my own personal risk of miscarriage was over 50% due to this (I had continually high LH levels compared to that of FSH which stayed consistently low). Clomid was of no benefit to me at all due to my LH levels (clomid can encourage further LH to be produced and this was clearly something I did not need) and I ended up having laparoscopic ovarian diathermy. This kickstarted ovulation in my case and it was successful. However, the cystic follicles do return over time.

As you rightly state as well charting ovulation is problematic if PCOS is an issue. The surest way I knew whether I was ovulating or not was to have regular blood tests done over a period of some months. This was also useful in that it showed clearly defined hormonal imbalances with hormone levels hardly changing.

I will offer this suggestion as well. If you are offered clomid later on in the year do ensure that you are monitored whilst on it. No monitoring is completely unacceptable as you will have no idea then whether its doing what its supposed to. Clomid's main job is to make the ovaries work harder. Do not let the GP prescribe it to you, it should be given under proper gynae supervision.

Are your day 2 tests okay?. Have they properly compared both LH and FSH levels?.

You may also find following a low GI/glycaemic load eating plan helpful in the longer term as this is more sustainable to follow.

Good luck to you and all on this thread.

[TremoloGreen]

Hi Attila. Yes, I have had all the blood tests. I am completely normogonadotropic - LH and FSH are normal. The ratio is very close to 1:1. I am also normoandrogenic, if anything hypoandrogenic. Also, no evidence of insulin resistance. I don't know why I have PCOS, but I do (my ovaries look like Swiss cheese on a scan ) and this coupled with oligomenorrhoea (i.e. a 38-day cycle) was enough for a consultant to diagnose me.

My point is, that PCOS is a broad spectrum these days, especially since the 2003 Rotterdam criteria. I probably have a completely different molecular pathogenesis to someone who has insulin-resistant, classical hyperandrogenic PCOS. Therefore, there isn't going to be one answer fits all for everyone on this thread. The chronic anovulation you are describing doesn't apply to everyone, I can't even find an accurate estimate of how many women with PCOS it does apply to. You also have to bear in mind that PCOS is massively under-diagnosed because many women don't suffer from infertility and their menstrual problems are minor.

I'm sorry to hear you have had a tough time; I am falling apart after less than a year of ttc, so I can only imagine.

I will be pushing for all the tests, don't worry. However, I am in London and I find the NHS is a bit under-resourced down here... basically if they can't offer them to me I will consider paying for private treatment with the consultant gynae I saw before through BUPA.

[bucksfizz1]

Dear All
I'm new to this thread so apologies for bumping in. I'm in the midst of IVF but I'm actually enquiring on behalf of a friend. She has just been diagnosed with polycystic ovaries and has been booked in for a laparoscopy in August by her consultant. I assume this is for ovarian drilling but at my IVF clinic they are not huge fans of this procedure. Is there anyone who can give me/her some advice about whether she should do this. She is on meds to get her to ovulate more regularly but I'm deeply concerned about success rates post this procedure - does anyone have any ideas about this? Does it work, has it been offered to you? Are there alternatives? I'd really appreciate your help with this. Many thanks in advance.

[AttilaTheMeerkat]

I became pg as a direct result of laparoscopic ovarian diathermy but its a procedure that should really only be carried out by a skilled surgeon who has had a lot of experience of such surgery under his belt. I know of others who have become pg as a result of this, equally know of some who have not.

This surgery is not the same as a laparoscopy which can be purely diagnostic; a lap is usually done if endometriosis is suspected.

[AttilaTheMeerkat]

Hi Tremelo,

I have been where you are now and you have my understanding.

I was a lean PCOSer when diagnosed. One thing amongst many that I have learnt about PCOS is that it is a very individualistic disorder and it affects each woman with it very differently.

I was not deemed insulin resistant either; another strange thing about PCOS is that not every woman who has this is insulin resistant. Its a conundrum; am glad that knowledge has moved on more these days with PCOS because when I was diagnosed way back when, it was not at all well documented.

With best wishes

A

[bucksfizz1]

Thanks Attila. I couldn't agree more and I am worried that her consultant isn't very good. I'll double check with with her tonight about whether it is for suspected endometriosis. I really appreciate your advice & I'm glad it did work for you. I'll have some more info & try and fill in the gaps. I'll let you know what consultant is suggesting. Much appreciated. x

[bucksfizz1]

Hi, my friend has been put on glucophage (also known as metformin) as a first line treatment for her polycystic ovaries. Her consultant has said to try for 2-3 cycles to see if it can regulate her cycle. After this, they've suggested clomid. I'm an endo suffererer and my knowledge of polycystic is limited so I'd appreciate if anyone can tell me whether they have had a similar course of treatment and if it's not successful what happens next? I've been reading your threads and see that lots of you have made dietary changes - do you know of any supplements or dietary changes (apart from no caffiene/alcohol) she could make? Much appreciated. x (Attilathemeerkat; no ovarian drilling just yet thankfully; as you said the lap was to check for endo but not until she's tried the drugs).

[RIBS]

Wow!! you lot are like PCOS experts. I have been told nothing about me condition, told yrs ago PCOS thats it. Im far from overweight so they've just left me to it. I had a hysteroscopy about 5 yrs after being diagnosed which resulted 2 months later in DD. Ive no idea if my LH is high or low. Could this have caused my MMC last December?

As ive been TTC I was given the clomid, but no scans or anything. Just a couple of day 21 tests. The clomid is working as ive had periods, with the EWCM +ov tests and BBT changes.

[RIBS]

freesea Fertility friend.

[KylieP]

How is everyone doing? Been on my second summer hol and I've honestly come back more relaxed about this whole business than when I left, I've been away with lots of friends and the distraction has really helped. Wonder how long this will last!

So I had a very weak AF whilst away, less than a couple of weeks after my constant spotting stopped. Has anyone has this AF craziness or does anyone have any idea what that means?

Oh by the way my sister in law is due, obvs I'm very happy for her (maybe a teeny bit jealous) and my mother in law says I should hold the baby lots as that kicks in hormones - really?!?

freesea fertility friend really made me laugh too!

[Jodidi]

freesea you made me laugh with the FF thing too

Af arrived this afternoon, well spotting but I'm sure it will arrive properly at some point tonight. That's a 30 day cycle this month which is way shorter than I normally have, although it was only 33 days between the miscarriage and next af. Maybe this whole mess is making my cycles more regular.

The bad news is that dp is still not coming round to ttc :( He's even bought condoms :( Any thoughts on how immoral it is to ttc without his knowledge, ie putting holes in condoms?