PCOS and ovulating late in the cycle - why?

[incy]

There was a thread on here a while ago where somebody mentioned that it was usual for PCOS to result in late ovulation in your cycle (CD18-20 etc). I think they said this can cause problems with conception. Does anyone know more about this as I have PCOS and have noticed I ovulate late (about CD18-20) and after months of trying on the 'right' day (according to the clear blue ovulatation test )I am not pregnant. Any info gratefully received.

incy

It is little point using OPK's if PCOS is an issue because these measure the amount of LH hormone present. If like many PCOSers, your levels of LH are higher than normal, the kit would be reading the excess and thus giving you a false positive result. My counsel therefore is to stop using the opk's with immediate effect.

PCOS is a very individualistic disorder and affects each woman with it very differently. How long are your cycles?. If they are very long indeed then the chances are you are less likely to be ovulating regularly if at all (you can have periods without ovulation). Some women with PCOS do ovulate on the occasional cycle but more often than not ovulation is affected to its detriment.

Are you receiving any treatment or are under the care of a gynae?. PCOS is a condition that should not be messed around with by GP's; specialist knowledge is often called for.

If you have been ttc for six months to a year now you should be seeing a gynaecologist for further evaluation and treatment. PCOS cannot be cured (the cystic follicles associated with the condition do return over time) but it can be managed and it is not an absolute barrier to conception. Many women with PCOS do need some form of treatment in order to conceive.

www.verity-pcos.org.uk is a good website to look at and should give you further information too.

HTH

Thanks Attila that is very useful information - have not been ttc for more than 6 months yet but will go along to GP when I have. I have already conceived (easily) with DS1 despite PCOS but I think it was just luck. Thanks again.

Hi Incy,

You sound in a similar situation to me. I have one DS, conceived on cycle 4 but with very long cycles (45-60 days)! I had a scan when ttc him and they thought I may have PCOS but couldn't say for sure. Now ttc no.2 and on cycle 5. I had a scan a couple of weeks ago and definitely have PCOS. I was a bit gutted as my cycles are much better since DS. I definitely ovulate every cycle and my cycles are now 33-36 days. To be honest, I don't think cd18-20 is late for ovulating and I bet lots of non-pcos women ovulate on on those days. Have you been diagnosed with pcos? If so, I would think the next step is to have a 7dpo blood test for progesterone to check you have def ovulated when you think.

Attilathemeerkat- I didn't realise that about the opk's. I only got a +opk on 2 days this cycle (the days where I had other Ov signs too). I've had the diagnosis but don't seem to be doing this pcos thing properly!

Yes I was diagnosed at 18 with PCOS through scans and blood tests - why it was such a surprise to get pregnant with DS ! Guess I had underestimated problems conceiving again and so when I reach 6 months I will def seek advice from GP. Only askde about late ovulation because somebody on here once said late ovulation common in PCOS sufferers and that it caused problems with the egg and so wondered what it was all about as had not heard of this before. Thanks for your advice.

Hi Panadaeyes

PCOS is a disorder that unfortunately (and thats an understatement) does not go away as the cystic follicles associated with this condition return over time. It can be managed but not cured. The causes of PCOS are not fully understood though there may be a genetic inheritance from the male side in there somewhere.

With regards to your 33-36 day cycles if blood tests are confirming ovulation that's great news but this is the only indicator I would use. Unless you are having blood tests I would not use any other indicator or assume you are ovulating as these could be wrong. Things like temp charts and opk's are not worth using if PCOS is present as both can give false positive readings (and with temp charts a chart akin to the Rocky Mountains which is impossible to interpret with any degree of accuracy).

Ovulation is not an exact science and a woman can ovulate earlier, later or not at all in any given cycle. With PCOS regular ovulation is less likely to occur, infact ovulation may not happen at all without medical assistance. It is though a very individulistic disorder.

You should be referred by your GP asap to a gynae.

ATM- You are right, there are cycstic follicles on my ovaries as there were before DS. To be honest though, my pcos must be quite mild as other than the cysts and slightly long cycles, I have no symptoms. I DO ovulate every month. If I chart, the chart is very normal looking (definitely no rocky mountains) and I get a +opk on the day of O etc. I guess I'm struggling to accept I have pcos but I have not conceived after 4 cycles so I am resigned to starting the horrid sounding metformin when af comes!

Incy- Sorry for the hijack. I hope this is your month

Hi Pandaeyes

Re your comments:-

"To be honest though, my pcos must be quite mild as other than the cysts and slightly long cycles, I have no symptoms".

PCOS is PCOS. It is though a very individualistic disorder and thus it does affect women with it very differently. My only symptoms were irregular periods and a couple of stray hairs in the nipple area. Came as something as a shock to me also, I had never heard of PCOS till diagnosis.

"I DO ovulate every month. If I chart, the chart is very normal looking (definitely no rocky mountains) and I get a +opk on the day of O etc".
Again (and I am sorry to say this) I would not assume you are actually ovulating solely on the basis of temp charts (you can have a temp rise in the second half of your cycle when an egg has not been shed) and opk's. Blood tests are the only accurate indicator here, if blood tests are showing ovulation then fabulous. OPK's measure the amount of LH hormone; with PCOS many people produce an excess of such a hormone and the kit will thus read that. OPK's are a waste of money if PCOS is an issue; spend that cash on something else instead for your good self!!!.

"I guess I'm struggling to accept I have pcos but I have not conceived after 4 cycles so I am resigned to starting the horrid sounding metformin when af comes!".

I think you are struggling with this PCOS issue like many women and I can empathise because I felt the same on diagnosis. You may not need metformin at all, it is not for all PCOSers to take. It is usually for women who show signs of insulin resistance (not all women with PCOS are IR). There are other treatments out there for PCOS (I had ovarian diathermy surgery) but as previously mentioned no one therapy or treatment will completely eradicate PCOS as the cystic follicles do return over time.

Verity is helpful and would suggest you look at their website for more information (infact I would say that to any PCOSer)
www.verity-pcos.org.uk

I would seriously consider asking your GP now for a referral to a gynae.

Attilathemeerkat,
Thanks for all your comments. I've been to the fertility clinic already and it is they who prescribed me metformin. I lied to them a little and said I'd been trying 7 cycles instead of 4.

I am definitely struggling with it all. I think I just want someone to say "Yes you do have pcos but give it a couple of months and you'll be pg" ha ha!!!! It's hard because my cycles were much more wacky and had a shoerter luteal phase when ttcno.1 yet we did it on our own. I must have though I would conceive more easily this time as my cycles are better.

I hate the thought of metformin but I'm going to get the prescription this afternoon ready for cd1