PCOS, hypothyroidism, no ovulation..need help!!

[vodkagn]

Hi all,

I'm 30 yrs old. I have PCOS, hypothyroid and I do not ovulate. The doctor had put me on prometrium twice until now to induce periods. I do get my periods after taking prometrium. I have not had any periods without medication. Long back I was put on BCPs too to induce periods, but now I want to concieve and hence the doctor suggested prometrium. He also has put me on Metformin pills which will help react better to the treatment. What I am confused about is that why is the doctor calling me for sono once every 1.5 weeks? Is this normal? He calls me for a sono once before I get my periods and then again when I am in the middle of my periods. The last time when I went to see him in the middle of my periods, he suggested that I take clomid. He gave me a very low dosage and this week when I went to see him again, he said that I have not been ovulating. He has called me for a sono next week and he is slowly going to increase my dosage for clomid. If that doesn't work then he is going to give me injections and the final treatment is going to be IVF. He had told me that I am perfectly fine and that I don't need IVF but now he is telling me to consider IVF. I am confused and depressed. I can't afford an IVF right now. He said that if I produce 8-10 eggs with clomid then he can't let me get pregnant on my own as that will produce 8-10 babies. Should I be trusting this doc or should I change my doc? He has been calling me for a sono before the periods, in the middle of my periods and after the periods. Please help me and advise if this is normal.

[Rainy229]

Hi, Vodkagn!

I'm sorry I don't have an answer to your specific question re:ultrasounds... but your post really caught my eye - I have PCOS and (subclinical) hypothyroidism and I wasn't ovulating for a while...  I had a blood work-up and was dx w/PCOS and put on metformin for (what they called "borderline") insulin resistance, I went on synthroid at the same time for the hypothyroid (my TSH was under what is considered "normal," but I had symptoms, and w/synthroid, my TSH dropped to a much more conception-friendly level and symptoms went away).  The RE I was seeing said that if I wasn't pregnant in 3 cycles, something was wrong and I'd "have to do clomid or something like that."  That was her plan.  I never went back.  I'm still on metformin (750XR twice a day) and am currently (against medical advise) self-medicating for thyroid (1/2 my old dose every 36 hours... long story).  And guess what - I'm ovulating (or at least my charts look like I am!)!  

Like I said, I don't have any answers for the sonography questions... but I do have to get on my 'lil soapbox... Healthcare is an industry (even if we don't like it that way), and you are purchasing what you like.  If you don't like what you're getting (service/personality/"bedside manner"/etc.), spend your money elsewhere.  You also have to advocate for your own health and your own goals.  Doctors have their own goals and thoughts on what you should do - if we're not careful, they'll just let us play out like their puppets - doing what "medical science" says they "should" be doing for us... Do your own research, ask tough questions, INSIST on answers to those questions, and stand up for your right to informed consent - if you're not informed and you just do what is being suggested, legally it may be "informed," but are you really???  I worked in healthcare long enough to learn that the system will just up and swallow folks, and that when someone is brave enough to stand up to it, they get noticed and (usually) they get results.  Don't get me wrong, I'm not saying that you are (or anyone else is) doing anything WRONG, just that we ALL need to stand up for ourselves when it's our bodies/health on the line.  Ok... I think I'll climb off this box now.  :)

So... to make a long story short - I'm not sure why all the US, but you should ask - and expect details (write them down), do your own research (however much or little is up to you!), and really KNOW what is going on w/your healthcare - you're the one paying for it!  :)

Hope that helps... 

Rainy

P.S.  I found acupuncture VERY helpful in getting my cycle back on track (even before I went on metformin)!  I would suggest trying a "community acupuncture" if there's one in your area, if not look for someone with a DTCM (doctor of traditional chinese medicine) or who can formulate Chinese herbs for you too.  :)

[vodkagn]

Thank you Rainy! I'm so new to all this..I should certainly do my research and not blidly trust the doctor.

Why can't I just get the ovulation kit and test whether I'm ovulating? Why do I need to go see him for a sono for this test?

[NishaG]

Hi, I have PCOS, as well.  I do not know why he is giving you so many u/s.  I would suggest referring to an RE and asking about the possiblity of using Femara instead of Clomid.

Also, try a website for women with PCOS, www.soulcysters.net .  There are many women there going through or have gone through the same thing.

HTH

[vodkagn]

Hi Nisha!

Thank you for your reply. My doctor is a RE. Today I had gone to see him again and I asked him the reason behind so many sonos. He says unless he does these sonos he wouldn't know whether I ovulated and then he did blood work (progesterone) to confirm that I did not ovulate. He gave me a very low dose of clomid and found out that the low dose isn't sufficient for me. So he aborted the whole cycle and now he has given me prometrium to induce my periods. Once the lining gets cleaned up, he will increase the dose for clomid and check whether I ovulated. So gradually he will keep increasing the dosage else next he will give me shots. I only hope and pray that I do not need to take shots. I'm already 30 and I don't want to delay anymore to have a baby.

Also, I asked him abt Femara and he said that if clomid doesn't work then he can give me Femara. He said its similar to Clomid.

I hope I'm in good hands!!

[NishaG]

Wellll... he doesn't need to give you so many u/s unless he is monitoring you to trigger (HCG).  a P4 (progesterone) blood test will confirm ovulation.  Have you had an HSG to check if your tubes are open?  Has your DH been checked?

How much metformin are you on?  You need to at least be taking 1500 mgs for it to work. 

Femara will induce ovulation, but, it works very differently from Clomid.  Many PCOSers (like me) are Clomid resistant.  I would ask to try Femara for a few cycles before moving on to injections.

Also, do you check CM?  If not, look into PreSeed.

I hope you are in good hands, as well.  Just know that you are the consumer. Don't be afraid to make suggestions and expect him to try them. 

HTH

[vodkagn]

Hi Nisha,

I went again for the u/s and I asked him abt  Femara. He said that if clomid doesn't work then he will give me femara. He also did a progesterone test to confirm that I did not ovulate. He has put me on prometrium for 6 days to induce periods. He asked me to go and see him for an u/s again within 3 days of my periods after which he will decide on a higher dose of clomid. This is my 2nd RE that I am trying. The first one didn't do anything for me. She hadn't even done a single u/s. She only kept checking my thyroid levels and this one is doing a lot of u/s.

[NishaG]

This makes no sense to me.  You should only have a u/s for a baseline and then after you have taken the clomid to see how your follicles are growing.  If he's not giving you a trigger shot, then there is no need to do so many u/s.

[Vybe]

I have been diagnosed with PCOS and my doctor told me my cyst were functional.  I thought that was odd and wondered why I wouldnt be given anything to strink them.  I was only told to exercise more and watch my sugar intake.  Does that seem od? 

[babygirlie]

omg I just wrote this huge post and then hit the quote button and it all disapeared ; ; I'm so sad lol Maybe I will write it again later. But to Vybe.. it means you ovulating.. Yes, losing weight helps PCOS symptoms.. but lucky us.. gaining weight and the inability to lose weight is a symptom of pcos!  So no seems normal. They recommend south beach diet (aka low carb) for pcos people
 

Quote:Originally Posted by Vybe 

I have been diagnosed with PCOS and my doctor told me my cyst were functional.  I thought that was odd and wondered why I wouldnt be given anything to strink them.  I was only told to exercise more and watch my sugar intake.  Does that seem od? 

[leilamom]

I have PCOS too.  I did two rounds of Clomid (i've also self-medicated several rounds of femara and tamoxifen, didn't ovulate) and my RE only did Sono on CD 11 or something like that to see if I had follicles growing, as he would trigger with HCG if I did.  I am current getting ready for an IUI tomorrow with my first round of injectables (I have 3 follies).  I started at a dose of 100 IU and had to do injections for 23 days with incremental increases every 3-4 days.  So, if you go that route, expect it to take longer the first cycle than they tell you, because for PCOS women, it takes a while to get the dose right.  I ended up at 275, with some response at 225.  I think for most women with PCOS, it just isn't enough with the oral meds, because our bodies just DON'T want to ovulate. 

[Vybe]

Thank you :-)  This gives me some relief.

[Vybe]

LEILAMOM Do you have a menstrual every month?

[subtlycrunchy]

Ack, just wrote a huge reply and it got cut off. I don't have any advice for what's going on with your doctor, but as for the PCOS, I found that making changes to my diet and exercising more made a HUGE difference in my symptoms. And I *think* this helped with conception, in my case. Have you consulted with a naturopath about the PCOS and hypothyroism? There might be some wisdom there, that that you are just not getting from your conventional doc. Here's a good article about taking a mind/body approach to PCOS from Women to Women.