PCOS Infertility specialists - recommendations

[KDxOx]

First time poster, long time reader!

Does anyone have a (London based ideally) fertility specialist that you’d really recommend for TTC with PCOS?

PCOS confirmed by my GP in March 2020 (with a sky high AMH of 196) and subsequent tests at ACU. I’ve had a pretty bad couple of years in my ttc journey, a mixture of needing more specific tailored treatment for my AMH levels, and more than my fair share of bad luck. However, all tests have come back fine (Hy-Co-Sy, lining structure etc) other than PCOS. Although it may not sound like it here, I am really positive and optimistic that if I could get myself ovulating, I could get my bfp naturally and soon. I just feel like I haven’t managed to find the right specialist, someone who knows their stuff about PCOS related infertility and with some compassion.

We’ve tried Clomid x 5 months with variable ovulation success (unconfirmed at the lower dose, but a thin lining on the higher dose) but no bfp, then our one round of NHS funded IVF ICSI which didn't go to plan (think along the lines of being the 1 in 10,000, in two separate ways… as well as poor management of my PCOS/drug dosage) but we did produce one 4AA blast on ice. One abandoned FET due to lining not thickening, and bleeding.

DH had sub-optimal semen tests during Clomid/ ICSI, but has since seen a Urologist privately and it was a simple fix and he has normal results now. His Urologist was great and was shocked and very sympathetic at my journey so far.

I saw an Endocrinologist in Autumn 2021, who put me on Metformin which I think has helped with my PCOS acne, but hasn’t given me a cycle, but neither did 2 years of inositol. The Endocrinologist was flustered still from her previous patient, I was rushed, was told I didn't have significant problems compared to her other patients and frankly I felt like I was wasting her time – needless to say I don’t want to see her again.

Really appreciate any recommendations!

I am currently being treated by Dr Timea Kovats. I see her in Brentwood, Essex, but the company and Dr Kovats also operate on Harley Street (London Women’s Clinic)

We are obviously still having treatment so I can’t give you a success story but so far we have been impressed with Dr Kovats. I’m a doctor myself, though not a fertility specialist. I have PCOS and am being treated with metformin. We are currently undergoing our first monitored stimulated cycle. Is this something you have tried? Dr Kovats recommended Letrozole rather than clomid as she has had more success with it. Happy to give more details if you need

Thank you I'll take a look at Dr Kovats.

I've had 5 monitored rounds of Clomid, the lower dose was inconclusive as we timed the progesterone test incorrectly; and I then had a higher dose, which interfered with my lining. I would like to give Letrozole a try, but my NHS ACU doesn't use it!

@KDxOx Our plan is basically:

1500mg Metformin daily (I’ve been taking for approx 2 months)

US Scan day 1 of cycle- looking to ensure lining is thin and all follicles are small to can commence treatment
5 days of 5mg Letrozole
Scan day 7 of cycle to monitor follicles - the follicular development will be monitored via scan. Ovulation “triggered” by injectable medication called ovitrelle.

Commence using ovulation prediction kit from the 10th day of cycle to monitor ovulation- then have to inform the nursing team if I detected a peak

We then get told when to have timed sexual intercourse

This time we are doing timed intercourse. If we don’t luck out we may do IUI next time