31 and terrified about infertility - PCOS? Low prog? What’s going on!

[Nic9485938]

Hi everyone

I’m really worried about fertility issues and plan on booking a GP appt soon and/or paying privately for tests, but in the mean time, I thought I’d pick your knowledgeable brains! I’m 31. Here’s a timeline:

*Started periods age 12. Very irregular periods. Had terrible acne and I was convinced I had PCOS but GP said no as I wasn’t hairy or overweight
*Went on pill age 16 to control symptoms. Acne never improved
*Went on accutane for acne three times aged 21, 25 and 29
*Came off pill aged 29 due to severe migraines. Periods were very irregular
*Had an NHS gynaecology appt aged 29 due to bleeding after sex. Turned out to be an ectropian of cervix but gynae did a transvaginal ultrasound due to my acne and said he could see 9 cysts on each ovary. He said it’s high but not quite enough for a PCOS diagnosis. Same with blood hormonal levels - technically “normal” but borderline. Said I’d have a tough job conceiving.
*Periods, for some reason, regulated after this point. Nearly bang on 30 day cycles for 2 years. But, I spot for 3 days before period starts.
*Started growing hair on upper lip aged 29/30
Got pregnant unexpectedly August 2020 aged 31. Had unprotected sex days 11/12 of cycle and 23/24, was surprised. Had abortion @ 7 weeks (September 2020) for reasons I won’t go into
*Experienced significant pelvic pain (particularly around ovaries) a few weeks after my abortion. I’ve now noticed this is cyclical and happens when I get half way through my cycle and stays til period arrives. Spoke to GP, infection ruled out, GP not concerned
Started noticing chin hairs growing October 2020
*Cycles have settled back really quickly since abortion in terms of cycle length, still 30 days which I’m pleased about
*Started tracking BBT with natural cycles November 2020. To my relief, my first cycle showed ovulation day 18, but a very gradual temp rise over 3 days. I also noticed my sticky/creamy cervical mucus lasts right up until AF arrives?
*December 2020 cycle, which I’m still in, is not good. Pain around ovaries again. Lots of sticky mucus every day. Huge amounts of bloating gas. No temp rise whatsoever and I’m on day 26! :( it had dipped right down to 35.8 this morning. So doesn’t look like I’ve ovulated at all/will ovulate? This has triggered my panic

I’m also still depressed and anxious as a result of my abortion and my sex drive is now non existent. I’ve been very stressed about it.

I’m very physically fit and healthy. BMI of 21.

I’m now getting very stressed about my fertility and that I’ve scuppered my only chance to have a child :(

My GP said to ring back in Jan if I’ve had ovary/pelvic pain again, so I will do this next week, and I think they said they will strange another ultrasound of my ovaries.

Is there any other fertility tests I could pursue privately to see what shape I’m in? Do people think it sounds like I’ve got PCOS? Or maybe low progesterone? I’m also struggling to pick apart the effects of a possible issue like PCOS/hormonal imbalance from general anxiety/depression and from anxiety/depression as a result of the abortion. Or maybe my body and cycles are still getting back to normal after the abortion?

Sorry, I appreciate I sound like an absolute maniac here (especially as I conceived in August so am clearly not completely infertile unless this was a miracle) but I really am very worried and fixated on all of this at the moment :(

Any advice would be helpful

Thank you

Are you currently trying to get pregnant? A lot of the tests will only be relevant at this point in time - there is little point doing them unless you will do something with the results.

Honestly the best way to tell if you will be able to get pregnant is to have regular unprotected sex, you were able to get pregnant 4 months ago so I would imagine you would be able to again.

Many many women have abortions and go onto to have successful pregnancies.

Having a few stray hairs isn't abnormal. Many women also experience pain/ discomfort around ovulation.

You've had tests for pcos and don't seem to fit the criteria.

Everyone worries about their fertility at some point, generally around early 30s when 'the clock' starts ticking.

As pp said, the best test of your fertility is trying to conceive...

It's very very normal to have a cycle or two where you don't ovulate each year. Maybe you were on one of those.

Biology (reproduction) is as much art as science. Up to 30% of women have polycystic ovaries without having pcos. It's considered a normal variant.

You need two out of the three criteriA:
Polycystic ovaries
Bloods - lh: fsh ratio of 2:1 or greater
Physical symptoms (excessive hair, weight etc...)

Pcos is an endocrine disorder. It generally responds to medication like metformin, or sometimes simply a diet change to a low gi diet.

I get that you fear you may not be able to have children in the future, if that's what you wish, but please bear in mind the women on this forum are living what you fear.

@physicskate

Having a few stray hairs isn't abnormal. Many women also experience pain/ discomfort around ovulation.

You've had tests for pcos and don't seem to fit the criteria.

Everyone worries about their fertility at some point, generally around early 30s when 'the clock' starts ticking.

As pp said, the best test of your fertility is trying to conceive...

It's very very normal to have a cycle or two where you don't ovulate each year. Maybe you were on one of those.

Biology (reproduction) is as much art as science. Up to 30% of women have polycystic ovaries without having pcos. It's considered a normal variant.

You need two out of the three criteriA:
Polycystic ovaries
Bloods - lh: fsh ratio of 2:1 or greater
Physical symptoms (excessive hair, weight etc...)

Pcos is an endocrine disorder. It generally responds to medication like metformin, or sometimes simply a diet change to a low gi diet.

I get that you fear you may not be able to have children in the future, if that's what you wish, but please bear in mind the women on this forum are living what you fear.

Thank you, I appreciate I may well be normal but I can’t shake the feeling I’m not. The acne, unwanted hair, pain around ovaries (I’ve had constant right ovarian pain 15 days and counting this cycle). But I really appreciate the reassurance and I will try to stop worrying

"Started periods age 12. Very irregular periods. Had terrible acne and I was convinced I had PCOS but GP said no as I wasn’t hairy or overweight"

Nor was I but I have PCOS all the same. That GP may well have misinformed you.

PCOS if it is present is a very individualistic disorder and does affect each woman with it very differently. The commonality though are the cystic follicles on the ovaries. Polycystic ovaries can appear larger than "normal" (i.e walnut) size on an ultrasound.

Would suggest you refrain further from temp charting; you can get a rise in temp in the second half of the cycle when an egg has not been shed so this method in itself is not infallable. Even women with PCOS can ovulate spontaneously occasionally and that scenario may well have happened to you.

Do not beat yourself up re the abortion and if you are not currently getting emotional support for this please do so.

I would keep a daily pain and symptom diary if you do not already do this as this would give a gynae clues. Progesterone is only part of the story. Re blood tests I would suggest having a day 2 test done to see what your LH and FSH levels are like in relation to each other. These should be the same but an imbalance of LH to FSH can be a possible indicator of PCOS.

Veritys website on PCOS may well be helpful to you:-

www.verity-pcos.org.uk/