Fertility investigations PCOS

[J90A]

Hi

I thought I would create a thread about pcos I have been referred to fertility and I have been diagnosed with pcos since I was 18. I have had all my blood tests which confirm pcos. Can anyone tell me what happens at the appointments and what treatments are offered? When I google I can find about IVF but not what’s tried first.

Hello
Hope you’re well!

It depends really- if they suspect you’re not ovulating once they’ve done your bloods and baseline ultrasound scan, or ovulation is irregular, they’ll probably try ovulation induction drugs first such as Clomid or Letrozole for a few months and see how you respond
Some clinics (Leeds for example) aren’t doing that at the minute due to covid and the level of monitoring you need whilst on the drugs (a fair few scans each cycle).

From there they’ll see how you respond, sometimes they suggest ovarian drilling/ ovarian diathermy but that involves a laparoscopy. I actually had that first as they were doing a laparoscopy to investigate endometriosis/Adenomyosis which I have too, so I asked them to do the drilling at the same time “while you’re down there... )

Others may have more info who have tried Clomid/ letrozole. Mine was a tad backwards.
I’m waiting to try letrozole to see if it works though still trying in the meantime :)

My struggle has been with the invasive stuff, it slowed me going through things and my current situation is taking clomid.

At first I wasn't having periods after coming off the pill and I went for an internal ultrasound. This spotted my PCOS ovaries.

I changed my diet and when I was having periods I had progesterone test every week from day 21. At first I didn't ovulate but I was working on healthy diet and started ovulating around day27.

Partner had to book for a SA.

Referral to clinic started with a video consultation, which resulted in going to clomid.

Before starting clomid I had to have a hycosy to check my tubes are clear, this was the first time I have had to go in styrups which for me was a big hurdle in my head. It's was fine really and I went private which helped me take a bit more control.

So now I am waiting for a new cycle to start taking clomid which is meant to stimulate ovulation.

Next step would be IVF, which seems to have a lot more invasive stuff, so although I do know I will do it, I really hope the next time I'm exposed is in labour.

Hi

Thanks for your replies!! I have an appointment next Tuesday for my first appointment although lockdown hasn’t helped with my weigh and my bmi is 33 from a healthy weight this time last year I think I will have to be at bmi of below 30 to even get any treatment ! I have an ultrasound tomorrow referred from my doctor so will see what that says! Xx

@J90A good luck with your ultra sound. Yes for my area they don't do IVF over BMI 30. It's tough coz I before I really understood it I had a give up phase and let my weight gain. Aim for 30 and go from there, they always ask about bmi

Hi thanks very much. She took measurements and confirmed pcos and said I had a swollen follicle meaning I might ovulate so I bought ovulation tests but nothing showing up! Does anyone have experience using them? I don’t have a regular period so I can’t predict when to use. But I’m wondering if the go positive when you ovulate from nothing. Or does the gradually get darker each day? Xx

Do not waste any more of your hard earned cash on such things. The use of OPKs is not recommended when it comes to PCOS and it actually states that on those kits. These kits are beset with problems anyway; they work on the principle that women only have one rise in LH every month and that such a rise is followed by ovulation. Both are certainly not true. These kits measure LH; as the level of LH is elevated in many women with PCOS the kit reads that.

IVF in women with PCOS should not be tried unless other treatment options (for example clomid, injectible drugs, laparoscopic ovarian diathermy) have failed. It may well be you will not need IVF anyway and there is a risk of ovarian hyperstimulation because of the polycystic ovaries.

BTW weight should not be a barrier into you getting treatment here.

Have a read also of Verity's website on PCOS:-
www.verity-pcos.org.uk/

Hi. Yes I understand that with pcos but because she said it looked like I might ovulate I though I would try just to see. It’s my understanding that bmi needs to be under 30 as the higher the bmi the more the pcos symptoms tend to be. So even if I can get treatment being over 30 there first suggestions will be to lose weight to regulate symptoms. I have been to endocrine in the past who advised a healthy weight can help with pcos.

A low Gi/GL eating plan can also help with regards to PCOS.

Colette Harris, herself diagnosed with PCOS has written cookbooks with this in mind.

Thanks ! I will take a look I was a healthy weight until this year (lockdown!) so hopefully get back on track. Xx

I have had to cancel my fertility appointment due to my partner having coronavirus. Re booked for February. I feel like I’m ovulating now! I have been taking my ova tablets again. I’m sure it’s them that work I thought was a coincidence previously. I would highly recommend them. Has anyone tried them? X

Update - had to cancel and reschedule our appointment as we both had coronavirus. New appointment date 16th Feb! some good news I got a period yesterday first one since august and after I started using Myova again. Too much of a coincidence to not have helped!! Highly recommend xx

@J90A good luck with appointment. What a drama to get there, hope you weren't too unwel.

And great about your period, I swear supplements helped me too. My 2-3 month cycles went to 6 weeks. And eventually ovulation.

@J90A Hi, I'm in the same situation as you, could you give an updates as what your appointment involved. I have my appointment on 22/02 and feel a bit anxious about it. Thank you!

[quote Knann]@J90A Hi, I'm in the same situation as you, could you give an updates as what your appointment involved. I have my appointment on 22/02 and feel a bit anxious about it. Thank you![/quote]
Hey I had my appointment today! I’ve to do a urune sample every week for 8 weeks to see when I ovulate. And I’ve already had a ultrasound scan. So the next stage is after is a die put through to check the tubes are clear and it will greatly away any debris aswell. It’s done similar to a smear. After that they’re gona start me on Clomid. Don’t be nervous they were very nice. Xxx

@J90A thank you soo much for the quick response!

[quote Knann]@J90A thank you soo much for the quick response![/quote]
No problem good luck

[quote Knann]@J90A Hi, I'm in the same situation as you, could you give an updates as what your appointment involved. I have my appointment on 22/02 and feel a bit anxious about it. Thank you![/quote]
How did you get on? Xx

Hey, sorry for the extremely delayed response! It was exactly as you said it would be, but I barely met the bmi threshold, so I just need to lose about 5lbs. I also had my hsg test today also, I worked myself up by watching soo many youtube video, but it really was not painful at all. They will be able to give me more info regarding treatment during our next appointment e.g ovulation and sperm count.

@J90A Hey, sorry for the extremely delayed response! It was exactly as you said it would be, but I barely met the bmi threshold, so I just need to lose about 5lbs. I also had my hsg test today also, I worked myself up by watching soo many youtube video, but it really was not painful at all. They will be able to give me more info regarding treatment during our next appointment e.g ovulation and sperm count.

[quote Knann]@J90A Hey, sorry for the extremely delayed response! It was exactly as you said it would be, but I barely met the bmi threshold, so I just need to lose about 5lbs. I also had my hsg test today also, I worked myself up by watching soo many youtube video, but it really was not painful at all. They will be able to give me more info regarding treatment during our next appointment e.g ovulation and sperm count.[/quote]
That’s good! I have been doing urine samples for 4 weeks to do 8 weeks to check if/when ovulating. I have a test in April to check my tubes are not blocked. I’m a bit nervous but they said it’s like a smear test. So should be ok. Xx

I have been doing ovulation tests on and off for a long time as with pcos I understand there not accurate. There’s usually no line but today I have this result. Will this be lee ovulation or post?