ANother vote for acupuncture/Chinese medicine. Best if you can get a Chinese acupuncturist who will do custom herb blends.
The Infertility Cure, by Randine Lewis, changed my life.
http://www.amazon.com/Infertility-Cure-Ancient-Wellness-Pregnant/dp/0316172294
As to the pain of the exam vs the "discomfort" some people have... that may be your tension, or it may be your sensitivity. And in fact, they are shoving a stick up there. It's actually a little bristle brush or a tiny spatula (depends on the doc, I've seen both used). I find it to be painful enough to jump - definitely more than "discomfort", but not extremely so. As for the pain on palpation, if you're cystic or have fibroids, that can cause pain. I pretty much always find those painful though, more painful right around my cycle, but painful regardless, and I don't have cysts or fibroids.
Ovarian scarring has nothing to do with PCOS. PCOS is a concatenation of symptoms. If you have more than X# of symptoms from a big long list, then you fall under the heading of PCOS. Cysts on/in your ovaries are only 1 possible symptom. And it can in fact be diagnosed fairly easily with a good history and careful observation (weight distribution, hirsutism and acne are fairly easily observed). Most docs do order hormone testing just to see what's going on, but if your OB is sending you to an RE, that's one of the first things the RE is going to do.
And I'm glad that your OB had a good RE to refer you to. A fat-friendly RE is such a blessing. I know mine never made me feel badly about my weight, and that was such a blessing. I can't say the same for the OB practice when I got pregnant the first time, though.
A couple questions for you though:
Have you been TTC, or are you skipping straight to seeing the RE? We didn't even try before starting with the RE, and as it turns out we probably should have, since #2 and #3 were spontaneous. [ETA - sorry, missed that on first reading.]
Have you done anything to attempt to regulate your cycles? Some people find acupuncture or Chinese medicine to be very helpful. Personally I found diet to be very helpful with regulating my cycle (as in what I was eating, not as in losing weight). Insulin Resistance (IR) is a very common symptom of PCOS, and since you say you've seen significant weight gain in the last few years, that would be my first thought, unless your eating habits changed drastically. Finding the right (and wrong) foods for your body can be huge when dealing with IR. Regular exercise can also be really helpful in regulating your cycles - it doesn't have to be anything strenuous, but even a regular long walk a few times a week can make a difference for some people.
Personally, I never found temperature charting to be at all helpful for me, but tracking my cycles and learning my body were both extremely helpful in knowing what was going on. I'd suggest picking up a copy of Taking Charge of Your Fertility. Even if you don't use most of the information in the book, there are parts of it that you may find quite useful as you go along.
There is a Plus Size Mamas/TTC group in the Social Groups section, if you'd like to join in there.
Pretty much all my symptoms pointed to PCOS... abnormally long/absent periods, weight gain, hair everywhere it shouldn't be, infertility (obvs), etc. I also didn't think an U/S was going to show anything surprising (although my doc did say the RE would probably do one anyway).
We have been trying, for over 4 years. Charting, OPK'ing, herbs, basically anything and everything that I could do that didn't require an MD to order or prescribe.
I've been researching some and have seen the insulin resistance thing. Does that mean that a diabetic diet would work to help my symptoms? Or basically any generic low-carb diet?
I may look for that group, thanks! I find it helpful to hear from women who are going through some of the same issues and concerns, that a thinner woman may just not deal with.
If you have insulin resistance a low carb diet will go a long ways towards helping. Be somewaht wary of a "diabetic diet" as quite frankly they still tend to be too high in carbs to really help. I have been ir for years with gd in both my pregnancies (I do have pcos) but thanks to my diet changes I am no longer ir - this was a huge thing for me.
This is entirely anecdotal, but FWIW:
I was diagnosed with PCOS in April 2010, based on elevated testosterone levels, an elevated LH:FSH ratio, and a history of anovualtion/irregular menstrual periods. Polycystic ovaries were confirmed via ultrasound in January 2011, I think. A glucose tolerance test came back negative for even minor IR (though some people have told me the A1C test is better). I've tried metformin a couple of times, and it has gone badly (non-stop headaches and nausea). I think that's partly due to it dropping my blood glucose levels too low, but I don't know.
After a failed medicated cycle (dexamethasone + Femara + hCG trigger), and two months of ovulating on my own but not getting pregnant, plus some precipitous weight gain, I went to a new OB/GYN (I'd seen two OB/GYNs and an RE previously), who suggested the South Beach Diet (low glycemic index diet) to help me lose weight. He was also going to put me on BCPs to help with the weight loss by turning down the testosterone production. I never made it on to the BCPs, because three and a half weeks and 7 lbs later, I was pregnant. Obviously, 7 lbs isn't a lot, but in my case, I was only barely in the overweight range (but still 25 lbs heavier than what has been normal for me), and 7 lbs was about 5% of my body weight, which most things I've read say losing 5-10% of your body weight really improves fertility, whatever your body weight may be. More than that, specifically, though, I think that the diet really helped with keeping my blood sugar levels stable, which made me feel fantastic, and, I believe, helped with my PCOS hormonal screwiness.
I've had to go off the diet because my morning sickness has made it so that I'll eat whatever I can get down, but I definitely intend to get back on at least a modified version of it later in pregnancy. I would recommend it for the blood sugar benefits alone, even if weight loss is not your goal. It's also a diet with several phases to it, and while the first phase is kind of tough, I like the fact that there are lots of tasty things (like steak!) that are totally allowed in it, and I didn't find phase two to be bad at all. I will say that there are a few suggestions I didn't really follow, like using products with lots of artificial ingredients, but I think it can still be followed reasonably closely with whole foods. Also, I took it at face value when they said to eat until you weren't hungry, even though later in the book it says there are some things (like nuts) you should eat in limited quantities. That was another thing I liked - I was never hungry. In fact, with the higher protein content, I got hungry way less often than I used to.
Anyway, I don't know if that's helpful at all, but it's something to consider. Again, not so much for the weight loss (though that is not a bad thing), but more for the blood chemistry. Whether or not that helps, I'm glad you have found a doctor you are comfortable with!
wow i just want to hug you for being brave and taking car of yourself!
on the PCOS front and your health in general, make it your goal not just o get preggo, but to really track down why you have had such a hard time up till now. i learned zoo much about my health when it took me years to get preggo myself.i was just a tad overweight and had seemingly normal cycles so folks kept saying nothing was wrong and wanted to just give me a bit of fertility drugs to increase my chances and be done with me. i would not stand for it.
i did uncover a case of pcos and a insulin sensitivity (then found out that my dad and grandma are both diabetics and never told me!) so i did a huge rethinking of my eating habits and wow it has really saved me. not only did i finally get preggo, but maybe even more importantly my pregnancy was healthy, i never got gestational diabetes and my life long outlook for avoiding diabetes and the related heart issues that have killed most of my family is so much better now.
had i got preggo easy i may never have learned all that i did about my body and my health history. it was a gift. but one i gave myself because i refused to let them take the easy way out, i requested all the test, eliminated all the other factors, then tackled the rest and won.
Well, dear, I'm sorry that you feel that way.
The fact is, I'm fat. Far fatter than your weight of 230. I have been my entire life, and will most likely be for the remainder of my life. If I waited to be thin before I had children, then I'd just never have children.
I actually found a fantastic RE, recommended by my OB/GYN, specifically because he doesn't discriminate against obese patients. The first thing he asked was why I was visiting him. I said, "Because I heard you were the only doctor in town that would help a fat chick get pregnant!" He didn't mournfully shake his head or start in with the serious discussion about my weight. He just said, "Yep!" with a big smile.
He never once mentioned my weight, and I only mentioned it with my introduction and when I told him I was in the process of trying to lose weight, and how much I'd had lost. He just said that was good, and went on to the next topic.
I came back to this thread today because I wanted to update those that had answered me and keet it positive. I actually ovulated today! First time in years! I was so happy that I literally had to hold back tears. But as it turns out, it wasn't me with the biggest problem in our TTC journey. My husband has no sperm, and probably some sort of blockage that will probably require surgery to reverse. So now we're just waiting on that.
Oh as soon as Katile used the word Dear, she lost all credibility. When someone starts with all sorts of caveats, excuses and buts...they are out to harm someone. We all struggle with different health issues and thank goodness we live in a time of wonderful medical science. I wish you the best in achieving your dreams, I too am struggling with health issues just of a different sort. Severe arthritis (stage 4 chondromalasia) and perimenipausal symptoms...low progesterone, high fsh, high estrogen and low egg reserve. It doesn't hinder me from trying my hardest to get the doctors to squeeze out a baby. No matter what we have the right to medical attention as anyone else.
Amanda - I'm so glad you found doctors who are eager to help you have a child and who make you feel comfortable and good when you visit them. This will not only help you in your journey to have children, but you are taking better care of yourself in general after not seeing an OB/GYN ever. It must have taken a lot of courage to make that first appointment and show up. I'm sorry to hear that your husband also has some serious issues to address, but it must be nice to know what's going on after wondering why you weren't getting pregnant for so long. It's good that you tested for that early on before you started expensive treatments on yourself. Congratulations on ovulating on your own! I wish you the best of luck!
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