Diagnosed with PCOS, Any advice

[roro87]

Hi All,

I had my DS in December 2020 (took 20m of trying) started investigating it while ttc with him doctor prescribed High strength folic acid, pregnant next month.

Currently trying for no 2 since September. Didn't want to wait as long this time as 35 this year. I ovulate every month, this has been confirmed over last 3 months. I had bloods and Hysoy, tubes clear, pcos confirmed. Been prescribed metformin, myo inositol and coq10. Hoping these do the trick as there is nothing else wrong that they've found. They are pushing IUI but only got diagnosed this month. I would like to give all this time to work before trying anything else. I'm going private so have to pay for each treatment so would rather give it a month or two.

Any advice welcome.

My Dr told me to go straight to IVF, he thouhht IUI a waste of time.

IVF didn’t work for me either because my ovaries aren’t happy, hope you are in a better position bjt basically my advice is to do all the reading on it you can and seriously consider IVF.

We can't afford Ivf until after we buy our house we have mortgage approval etc and an offer on one.

So we have until September October anyway. Iui we can afford as much cheaper but I don't rate it at all.

My plan was take the supplements and the medication until we can afford ivf. I just feel so pressured by my consultant to try iui.

I hope something works out for you in the future.

It's so hard to know what the right thing to do is.

We made it clear at the outset that IVF was not in our price range and we weren't going to take out financing to do this, so my dr. suggested IUI right off. It was successful.

The diagnosis and treatment plan are interesting to me, though. Generally the issue with PCOS is ovulation and you've already confirmed ovulation for three months presumably by ultrasound to monitor the developing follicle and subsequent corpus luteum to show ovulation so I'm not sure why metformin would be prescribed, same with the myo-inositol and coq10. All of these things are great for getting you to ovulate but you're already doing that, so it seems like the wrong protocol for you and adding extra time to the process.

I have PCOS I'm on 1500mg of metformin a day which helped loads. It regulated my periods (I also lost nearly 4 stone in weight which also helped as well) and I was able to fall Pregnant naturally Sadly I miscarried at 9 weeks but when I had my scan done my ovaries were clear from any cysts. Before I started on the metformin on previous scans during my PCOS check I had something like 21 cysts on one of them. The only thing they did notice this time was my right one was more enlarged but that was it. Came off the metformin in 2020 basically to give my body a break as that pregnancy was our 4th loss. My weights piled back on and I've probably had about 4-5 periods in the last year and a half. Back on it again and I've just finished one so I'm hoping they'll regulate themselves again. One thing the gynaecologist did say to me was because PCOS can cause insulin resistance then working to fix the pancreas first, then helps everything else fall into place

I think it for egg quality but yes I was a bit suspicious. I'm moving clinics anyway just not happy with the pushiness. I was literally just on folic acid 5mg for my son, less than 2 years ago so definitely had it then too

Supplements to support egg quality
CoQ10. Coenzyme Q10 is an antioxidant which may protect eggs during maturation against oxidative stress. ...
Myo-inositol. Myo-inositol is a type of b-vitamin, probably better known for its role in PCOS. ...
L-arginine. ...

So probably correct on two but wrong on metformin.

Unless they specifically mentioned that you have egg quality issues, like follicles developing slowly or too few follicles, there's nothing to improve. Since you've had the monitoring ultrasounds and don't mention that, I'm going out on a limb and assuming that's not the case.

You also don't mention if your glucose/A1C are high. That's what some research links to PCOS-related fertility issues, but again, usually the first sign of that is not ovulating (or a "weak ovulation" confirmed in bloodwork & ultrasound.)

So yes, I think they could have used a more aggressive protocol and this seems like a bit of a placeholder treatment plan.

Glucose is completely normal. Thyroid and prolactin were a little off so on treatment for that but now normal.

They felt that egg quality was an issue due to size and there being so many follicles.

I really feel they want me to do multiple iuis then move on to ivf. I feel it is all about maximising profit out of me.

If your E2 levels were normal and the eggs matured and released in the right time frame, egg quality wouldn’t be a likely factor.

If that’s the case then IUI would likely be successful. It’s got a higher success rate than timed intercourse and nothing you’ve said indicates IVF would be needed so why would you do it?

They could hardly keep you doing cycles and cycles of IUI if it had every chance of success.

I agree the protocol seems off, but I’m also aware that I am making that judgement based on these details and not the full picture.

We could aim for July cycle for iui. We live 2 hours away from our clinic so need to take a half day off work for evert appointment so want to wait until then.

You can focus on improving egg quality with lifestyle, diet and supplements in order to give your ivf cycles the best chance. Good luck, but like you said try to avoid the endless cycle of iuis