TTC - regular cycle, PCO (not PCOS), difficulty with ovulation, advice on supplements

[SabaScarlet]

Hi all, first post here.

I've been TTC for around 15-16 months, since October 2014. I'm 23 and I was previously on the pill for 3-4 years (initially cerazette, then mercilon).

I fortunately have regular cycles, slightly long at approx. 32 days. I have been tracking cycles since Dec 2014. I have also been using OPKs (the cheap ebay ones) on and off for the past year, and most months I have used them I have been getting a positive around CD16/17, so assumed I was ovulating around CD17/18. I haven't been temping as the OPKs seemed easier and I wasn't having trouble getting a positive on them.

I think I might have had a chemical pregnancy in Jan 2015, there was a faint positive one day but it had disappeared the next, and my period was about 3-4 days late and much more painful than usual. Also had one other late period in July 2015 but was away and couldn't get hold of pregnancy tests.

I went to the GP in Nov 2015 as it had been a year of trying and got my FSH, LH, and progesterone blood tests done as well as pelvic and transvaginal ultrasounds. The FSH and LH are fine (7.1 FSH, 9.2 LH), the progesterone is a tiny bit low (27.0) but having it redone a bit later this month as I have a long cycle.

However, the ultrasounds showed I have lots of cysts on both ovaries. The sonographer said GP would collate this with bloods to see if I have PCOS, and GP is testing a few more bloods this month, but she thinks PCOS is unlikely as I have literally none of the other symptoms. She also said none of the follicles looked mature enough and it didn't look like I was ovulating or going to be ovulating (it was CD17, and I'd had a pos OPK that morning, so I should have been). I'm really confused though as to how/why I'm getting pos OPKs if I'm not ovulating. Is it possible to regularly have a LH surge and not ovulate?

I'm not really sure where to go from here. I'm not eligible for fertility treatment as I'm underweight and under the BMI requirement - I have been trying to gain weight (even tried nutritional shakes) but with no luck, but as my periods are regular my dr is not actually that concerned by the weight.

I've been taking pregnacare conception for about 6 months, and I've had months where I've dabbled in agnus castus and royal jelly. I'm thinking of starting a new regime and focusing on agnus castus, B6 (+B12), and progesterone cream, as well as the pregnacare. Possibly also coenzyme Q10. I've read a million and one things on all sorts of supplements but these sound best for my problems - would you agree? I was also tempted to try soy isoflavones but advice seems to be don't do it if you have a regular cycle.

While I'm wary of self-diagnosing, I feel I can gather from what I've had tested that my issues are related to my eggs being too immature, potentially my luteal phase being short (if I'm ovulating way later than the pos OPKs), and some sort of trouble (if/when an egg is conceived) with implantation.

Any advice for me?

Hi there!
It sounds like you are PCO but without the syndrome, as the 'only' symptom you have is cystic ovaries.

Having a regular 32 day cycle is a fantastic head start on most people with PCOS. I don't have cycles at all and can go 110 days or more with no AF! So I have to take Provera (a progesterone) to induce a bleed. regularly.

A regular cycle would usually indicate that you ARE oving. Most people who don't ov (like me) have random and varied cycle lengths which are extremely unpredictable. However there is no way that you can be sure of this without both committing to temping each morning before you move AND asking for some blood tests to confirm that oving is your problem. Once you are armed with this knowledge (if it is the case that you're not oving) then your doctor will have to refer you to a specialist as you can't be expected to continue ttc with no ov and zero chance of success! You would probably require clomid to kick start your ovaries.

Unfortunately opks are not a reliable method of predicting ov when you have PCO/S. I regularly got false positives (when blood tests for 10 weeks in a row confirmed defo no ov!) and false negatives (when clomid made my ov the opk stayed negative!)

So I wouldn't time DTD around their result alone but use them alongside temping and blood tests.

Finally in relation to your weight, I also have a low BMI and lean-PCOS. My fertility clinic had a lower BMI limit of 18 which I just about met. However others I have met have been told to get their BMI to 19 or 20 before they can be referred.

My best piece of advice is to come and join us on the TTC with PCOS thread. We are all at different stages and all have different stories but we are all helping each other to reach our dream. Some have severe PCOS, some milder PCO. Hopefully I'll see you over there. X