PCOS, specialists in London and TTC queries

[hmc34]

Hi all,
New to the forum. I’m 34 and think I meet the criteria for PCOS (polycystic ovaries on scan, high testosterone and abnormal hormone profile). I’m waiting for follow up appointment with GP.

I do have regularish periods (though notice my cycle has become abit shorter over the years) and my BMI is at the top end of the normal range. My partner and I will be trying to conceive later this year but I am worried about conceiving given the PCOS and also my age being 34.

I know peoples experiences with PCOS seem to vary quite a lot but I had some questions:

1. If I am having monthly periods with PCOS - would the first step be to TTC naturally? Or do they start Clomid straight away with PCOS?
2. Should I see someone privately now? - I imagine nhs waiting list will be very long. And if so, does anyone have any good London recommendations? Would this be a gynaecologist or an endocrinologist?
3. Is it still worth tracking BBT and using ovulation strips in PCOS if I still have periods or are these totally unreliable?

Thanks in advance. I’m quite anxious because I was already quite worried about TTC at 34 and now feel like this is a second blow even though I understand it is possible to conceive naturally with PCOS. I am going to try and loose abit of weight but it is difficult and I’m probably at the upper range of the normal BMI.

thanks!

How are you getting on ?
Im waiting to hear if i have pcos

I have PCOS. First baby conceived with metformin + letrozole (more effective version of clomid with fewer side effects) on the NHS at St Thomas' when i was 34. Referral time a bit irrelevant as it was during covid. Now going for #2 at St George's. Mid process but it took 4 months from GP referral to first appt then 3 months wait until next appt during which i had blood test / scans / DH sperm analysis. Now 36 so conscious of time so hoping for progress at the next appt!

I found endocrinologists were better at getting a plan for controlling the PCOS but all fertility treatments were done through the gynae / fertility clinic.

Ovulation strips dont work with PCOS as you can have multiple LH surges with no ovulation but BBT tracking is cheaper so no harm i suppose!

I found Fast 800 diet worked really well for me. I've lost 10kg in 10weeks so far. Lots of women with PCOS also swear by inositol to bring back regular cycles.

I have severe pcos and find ovulation strips 100% reliable. I've had scans to confirm and they correlate with the positive ovulation tests.
I also chart bbt and highly recommended it.
I also recommend trying myo inositol while your waiting.
I went from have zero -1 or 2 periods a year to ovulating every cycle with one pregnancy at christmas (loss) also used ovulation tests to confirm that ovulation. That was after so many years trying, so I definitely think the inositol has helped .
I was put on clomid few months ago to try while were awaiting ivf.
I personally don't recommend the 800 diet as mentioned above. It may work for some but be very careful as its calorie restricted. I lost a shit ton of weight in a short time I was only on it 2 weeks ( I lost 9 pounds in 2 weeks on it) It completely ballsed up my last cycle and I had a very late ovulation / i was struggling to actually release the egg ( only month this has happened) and while on clomid. My luteal (ovulation to period) was also very long . They also said my follicle looked abnormal that it didn't look like it developed right . Obviously i cant say for certain that caused it but I feel like the calorie restrictions really messed with my body this month. Everything seemed off and , including now my period .
I discussed this with the fertility clinic when they weighed me , they mentioned I'd lost weight since my last appointment and I told them I was following the 800 and they told me come off it straight away. They said especially since your preparing your body for pregnancy you should be following a sensible healthy diet and certainly not a calorie restricted diet of 800 calories.

I have PCOS and TTCed naturally but my consultant told me to get in touch after 6 months, rather than the usual 12 months (I think), if nothing happened. You may already be ovulating, you could try and track ovulation yourself if you wanted.

Have you tried inositol? It changed my life. I just get it from myprotein and take a teaspoon a day. Conceived in 2 months.

I also made some lifestyle changes like healthy bmi, resistance training (no HIIT as it can raise cortisol) and lots of steps each day.

The month is conceived I also did seed cycling but that was probably just a coincidence. I liked the seeds though so no harm!

I think the fast 800 probably depends on which type of PCOS you have? Mine is insulin resistant and a "sensible diet" doesnt work for me. I gained 3 stone in 18 months by eating "sensibly" and my cycles got worse. I went from 60day cycles to 80-90 days. Since starting Fast 800, ive had two x 38 day cycles, which makes sense as its designed to work for pre-diabetes, so hopefully having a positive impact on my insulin levels. In any case, my consultant asked me to try and lose 10% of my body weight as this can support a resetting of cycles, and ive been able to achieve this. My most recent scan also showed a reduction in the number of follicles compared to pre DD1 so it does seem to have been effective for me.

Everyone has to do what is right for them.

@CrispAppleStrudels
Hey , I do have insulin resistant pcos. I was diagnosed as pre diabetic last year and put on metformin.
Glad to hear it worked for you. I found it absolutely horrible. Past year my cycles have been as close to perfect as I've ever had until I started the 800. I'd seen gynae last Tues aswell and he also said he was against it. I got him to take bloods to check my hormone levels as he said low calorie diets can affect your hormones.
I just hope I haven't fucked myself up. I only followed it for a few weeks but it definitely feels like it's altered my whole cycle. The clinic told me you need an adequate amount of calories and nutrition to put the energy into supporting healthy egg quality and maturing of an egg and that it's not sensible to go on such a diet then expect my body to carry a pregnancy .
After hearing that my follicle was an abnormal shape, whatever that means and how my cycle has been affected, I don't think I'd ever attempt 800 again.
The worst of it is by the end of the week after id stopped, I'd gained back every single lb I'd lost plus an extra 2. From hearing others experience that seems common. I lost a stone earlier in the year as I had to get my bmi within limit . I did intermittent fasting and 1200 calories daily. I cut down the crap as much as possible but I also didn't deprive my body if I wanted something, so long as I wasn't going overboard and after I'd had my appointment I did kinda revert to my old ways but I kept all the weight off, bar 2 lbs, which was amazing .
I think its one of those things , it might work for someone and for another like myself, it can have a negative impact. If someone else is doing it and having success, good for them. I just would never recommend it to anyone. I do need to lose some more weight but I certainly don't want to compromise my egg quality, especially during a time when I'm trying to conceive as ill be doing an egg collection in the coming months. I worry with pcos that my egg quality is already shit enough

Hey,

I have PCOS & conceived in 6 weeks.
About 2 months before starting trying I had an appt with the gynaecologist specialist at my GP. This was somewhat luck that we had one.

She advised me to start taking folic acid before conceiving and not to worry about tracking cycles too much but (shockingly) to have sex regularly every other day or so. She also explained that I would have 9-12 months trying naturally, then explore options such as clomid & another medication, then IVF if we’d had a year of that not working.

My partner and I did also both take fertility supplements for a few months before, I took inositol, not sure what he took but if you search there are male supplements too.

I also lay with my legs up on a pillow after each time.

I also lost a significant amount of weight (20kg) and was in the ‘healthy’ BMI range when we started.

Good Luck! Big hugs and try not to stress about it too much!