PCOS help needed

[2007Millie]

Very rare periods, maybe 1-2 a year with no warning/regularity/routine etc, totally random. Have been like this since I was in my teens.

Diagnosed PCOS.

Any tips on conceiving?

Average weight etc as I know normally the first thing is to lose weight and eat healthily, but I already do that.

Medication/pregnacare tablets etc

Just anything that might assist

Hi . Have they put you on metformin or anything to help shorten your cycles. I also have pcos and my doc put me on it two years ago to try and shorten my cycles. Still not 28 but at least every two months now instead of every 6. Losing weight also helps. Have you got any tests done to see if you ovulate etc??

hi - yes I'd recommend Metformin too. I have PCOS and started on it after TTC for over a year - was pregnant within 3 months. Could have been co-incidence, but definitely worth discussing with your GP.

In conjunction with metformin I’d look at lifestyle. Especially the reduction of inflammation in your body by cutting out ALL sugar and refined carbohydrate (bread, pasta, pizza etc)

Basically go keto / blood sugar diet / low carb

It’s pretty much proven that it is an insulin related disorder and you need to lower your insulin

Hello!
Thanks for all your response.

Nothing from doctor yet as didn't think they would help until I had been trying a while.

No tests regarding ovulation, can I do this myself with the tests I think you can buy from boots?

I definitely love carbs and didnt realise that I should cut that out so I will try that.

You can tell I've not really thought about it in years! Just got diagnosed as a teen and then put it to the back of my mind

I think you should go to your GP earlier rather than later at least just to discuss. You have oligomenorrhoea with a known cause. The NICE guideline clearly states that women in your position should be considered for referral earlier than the standard 1 year of trying:

From the NICE infertility guideline here (I’m not saying you’ll necessarily have fertility issues and don’t mean to scare you but this is the relevant guideline if you need back up)

cks.nice.org.uk/infertility#!scenarioRecommendation:7

“ Consider earlier referral if the following factors are present:
In women:
Age 36 years and older (refer after 6 months).
Amenorrhoea or oligomenorrhoea.
Previous abdominal or pelvic surgery.
Previous pelvic inflammatory disease.
Previous sexually transmitted infection (STI).
Abnormal pelvic examination.
Known reason for infertility (for example prior treatment for cancer).”

I waited for a year before seeking help (didn’t know I had PCOS) and it was really hard. Then the referral takes time and there are several medication options all of which need trying for months and it just goes on and on. At least have a conversation and flag your concerns. You might not get referred straight away but you could maybe agree to try six months instead of a year or something.

Agree with low carb as per pp (there is good evidence for this in PCOS) but be careful with ovulation tests. They are not recommended by NICE and are especially inaccurate in PCOS (covered in the above guideline as well). Also you have no idea when you might be ovulating so would be testing loads (as you can’t just test around the middle of your cycle). Take it from me that it gets very expensive and very disheartening when they’re always negative. My obstetrician said to throw them out.

I cannot advise on medication as things may have changed a lot since my diagnose and having a child almost 20 years ago.

The only thing I know, that has not changed, is that if you are as irregular as I was ( my periods could be anything from 1 month to 7 months apart) there is no way on Earth you can get pregnant without especialised medical assistance, This falls beyond the expertise of a GP or a dietitian, you need to seek a referral for a gynaecologist and push for tests, do your own research and ask the doctor to be totally honest about your chances and how to improve them.

I was told by my fertility doctor to take Myo inositol supplement alongside folic acid and I'm currently cuddling my ten month old!

Before you start cutting carbs out of your diet... how is your BMI? I have PCOS but my period practically disappeared when I was underweight. intermittent fasting can also alter your cycles even if you are not underweight.

Wow, so much information and lots of things I've never even heard of or considered. BMI is 24 so 'average' for my height etc.

Think I will book an appointment with my GP once this is all over to maybe start some medication.

Not immediate rush as in my mid 20's so do feel very lucky that time is very much on my side

If your doctor is doing phone appointments, I'd have thought this is absolutely one that can be handled by phone. You have PCOS (I assume she has the test results to confirm this?) and you can tell her your vital statistics vis a vis weight, height, general health etc. I see no reason why, at the very least, your GP can't a) prescribe Metformin to see if that has some impact and b) refer you now to gynaecology. Because the next step, if Metformin doesn't work, is Clomid to make you ovulate.

Incidentally, it depends on your trust obviously, but overall, even with confirmed PCOS, as far as I know the NHS won't go straight to Clomid until they've done full investigations. I find this mind boggling as Clomid is cheap and simple and if that's ALL that's wrong, there's a relatively high chance of success. But it is what it is. In which case, if you can afford it, you should seriously consider private as, relatively speaking, it's very reasonably priced to get fertility treatment for PCOS privately.

For context, in my case, I had an initial consultation with a few tests (bloods and internal exam - nothing too crazy). Was prescribed metformin. A few months later I returned, discussion and internal exam followed and Clomid was prescribed. There was a brief delay and the requirement of an additional appointment as a result of a follicle that just kept growing and then basically got stuck but I think that was sheer bad luck. Clomid. In first month, had appointment and scan to assess follicles. Told not to come back unless pregnant or after 3 months. Was pregnant after second month.

The point is that even with crazy private prices, the above is all relatively inexpensive and about 500 times quicker and less invasive than via the NHS. Obviously, if you don't have the money, you have time to go through NHS, but it's worth considering (appointments for private doctors will vary but think between £200-£500 a session plus cost of some blood tests. Some will charge separately, or as a separate appointment, for the internal exam/scan). I paid £5 for two months worth of Clomid.

Thanks @BlingLoving that is really helpful.

Already go private for contraception (Dianette) as the NHS wouldn't prescribe this even though in my experience it's brilliant, so I am financially able to go private comfortably.

Think I'll try my local doctor and if there is any resistance, just head to the private GP.

Really good suggestion, thank you

Someone very close to me after 10+ years had a baby and what worked in the end was homeopathic treatments.

@2007Millie - your NHS doctor should be able to refer you directly to private gynaecologist if you are happy to go that route (or, if you have a private GP for your dianette, she can refer you directly to a gynaecologist or fertility specialist). For Clomid, you DO need specialist care, not a GP so I'd go straight there. If your NHS or private GP is willing to give you metformin, you can always start that before you meet with the specialist - as long as you have records etc, that is fine. They may want to do a few additional tests, but certainly mine was quite happy to accept the previously done confirmation of PCOS.

Thanks for the help everyone.
Local GP was reluctant to prescribe anything, and private GP is holding very very very limited consultations due to everyone working for the NHS.
However, Dr Felix online website has happily prescribed 168 500mg tablets of Metformin.
Am I right in thinking I take 1 a day for 7 days, then 2 a day for 7 days, then 3 a day for the remaining time?

I'm assuming if this doesn't work, I can then move onto clomid?

Thanks

Hi. I'm constantly on metformin. It is used more for control your cycles then ovulating. I went on clomid with metformin and I'm soon to be on letrozole along with metformin. Two things though. The first while you use metformin its gonna upset your stomach alot . You just need to stick with it. And watch what you eat with it. I find alot of sugar and and my stomach is in bits. Secondly do not take clomid u less you are under the supervision of your gp. You need to have follicle scans done to make sure it's working and that your ovaries are not over stimulated. Unless you want to end up like octomom

My first baby was conceived after taking metformin for 2 months whilst continuing with all the other health targets. This was after 2 yrs of TTC. I had a BFP the day I received my letter for the IVF clinic

Tried again 3 years later but for 2 years nothing happened until I had an ectopic pregnancy which resulted in surgery and the loss of my left
Fallopian tube.

A year later another miscarriage.

And then finally, nearly 8 years after the birth of my son, my daughter was born. After giving up trying and despite having PCOS/only 1 remaining tube, I fell pregnant unexpectedly. I'd been told it wasn't going to happen and that due to my hormone levels being so high I was not eligible for help from any clinics etc.

I took myo inositol a while before giving up ttc for the second time but other than that I wasn't in the best of health (had started smoking again and put on LOTS of weight) due to depression from the miscarriages.

Unfortunately had gestational diabetes during this pregnancy but managed that with meds and diet.

As an aside and something I wish I knew about when ttc is the keto diet which I have followed for the last 10 months to manage my hormones/weight/insulin resistance. A few ladies in the group with PCOS have fallen pregnant since being keto (at least 3 that I can recall) and within a matter of months.

I hope you get your BFP soon

I keep reading about myo inositol... where can I get this?

Hi OP,

I've got PCOS, diagnosed about 6 months ago. Been trying to conceive for 2 years with a MC in between. I was put on metformin but had to come off it and wasn't given correct dosage etc... but I've started it again yesterday, 500mg a day for a week then onto double that a day after. I'm crossing my fingers it works! Also I've started Myo inositol today so I'm going to see if that makes a difference. I bought mine just from an online vitamin store, it was reasonably priced so can't hurt!

Giving this a go then thinking of going private if my doctor won't prescribe clomid.

Crossing my fingers for you to conceive soon xx

Right so I've purchased...

Metformin
Folic acid
Myo inositol
Vitamin D
Iron
Vitamin B6

Hopefully this will work!

Honestly OP, do not want to be mean, but with 2 periods a year and an egg only viable to be fertilised for 12 - 24 hours after ovulation, you would need to have sex everyday not to miss up on your next fertile day.

You need to bring your cycle to be more regular and predictable. Take all the stuff you bought but push for an appointment with the gynaecologist as well. 🙂

Not mean at all @TheMotherofAllDilemmas

Lucky sex life is rather good and generally daily, so hopefully that is on my side.

Once this pandemic is all over I'll push the doctor for more help and keep my fingers crossed

I also have PCOS, tried for 12 months with my first then doctor put me on Clomid and I fell pregnant second cycle on it.

This time for my second I was on clomid straight away as well as metformin, took 5 months to fall pregnant, had an early miscarriage, 3 months after that fell again but had another early miscarriage, found out after that that I have a MTHFR gene mutation which affects how your body processes synthetic forms of folic acid so I cut all synthetic folic acid out of my diet, take the proper folate supplements and also an EPA/DHA supplement and n-acetylcysteine, fell pregnant 3 months later and now 12.5 weeks.

I’ve also been on progesterone since I got my positive test because low levels can contribute to miscarriages.

Hope this helps and hope you fall pregnant quickly

I was very similar to you- average weight but diagnosed with polycystic ovaries and two or three periods a year. I took a combination of Agnus castus herb and dong quai Chinese herb and this regulated my cycle and helped me conceive. After I gave birth and stopped BF my cycles regulated to monthly (never had that before) and I conceived my second child quickly and unexpectedly. Dong quai is harder to get these days but you could ask in a Chinese medicine place. Good luck!

It's actually counterproductive to have sex every day. Male sperm needs two to three days for the count to replenish enough for optimal motility and viability of the sperm