TTC with PCOS

[lexbeach]

Hi Mamas!

After years of saying she would never want to get pregnant, my dw is suddenly wanting to try, like ASAP! I am THRILLED : to say the least. The one complicating factor is that she has PCOS.

When I met her 10 years ago (she was 21), she was on three different medications for an unspecified "hormone imbalance," mostly to treat acne and facial hair. One medication was the bcp, and I can't remember what the others were, but eventually I got her to stop taking all 3. From her symptoms, I thought she had PCOS, and she eventually did get diagnosed (via u/s showing polycystic ovaries) a few years later. She hasn't been medicated for PCOS or her symptoms for several years, and in the past year her cycles have become *very* regular (usually 28-30 days, though her flow is light and only lasts 3 days), and she even has some symptoms of ovulation (CM and cramping mid-cycle), though she hasn't tried charting or using OPKs to confirm. She doesn't have the weight gain symptoms (she's a healthy weight) of PCOS or the insulin resistance issues (she has this tested every year and the results are always great). She is in great shape physically.

If we had sperm on tap, we could just ttc and see what might happen. But since we have to buy sperm (and it's not cheap) and pay for the inseminations, we're thinking we should investigate this PCOS thing and see if dw should be on metformin or clomid or a combination of the two. Even if she is ovulating on her own, doesn't PCOS often cause miscarriage? And metformin can help with that? I don't really know much about it all since I never thought this would be a possibility. So, I'd love any info/advice anyone has to share.

Dw does have an appointment to see an RE next week, but we're not sure if we'll be able to keep the appointment (have to check out insurance coverage). Would a regular OB/GYN be able to help her?

Thanks!

Lex

[lifeguard]

I never saw an re just an ob who specializes (unofficially) in fertility. Things sound really positive that she may have her pcos under pretty good control naturally.

Why don't you chart for a couple of non-trying cycles (I know it's hard to be patient but since you are paying for sperm it would be preferrable to only use it if she is oing)? From the charting hopefully you will get a clearer indication of whether or not she is oing & it will be more clear if you need to proceed with any drugs.

While the evidence does seem to show that continuing metformin throughout at least the first tri to help reduce the risk of miscarriage I have not read anything that says you should start it for this reason alone.

Good luck.

[dachshund mom]

I second trying to chart for a couple cycles. She's probably Oing if she has such a regular cycle and CM, so you just need to figure out which day it is. Clomid can bring along it's own problems like drying up CM.

I'm also not IR and am a average weight, but I did a really strict low carb diet and cut out estrogenic foods like soy. The PCOS group in FYT was a ton of help. My RE did not recommend metformin.

I'm reading about miscarriage a lot lately and yes, it's a higher risk. They don't know why, but it could be high androgen levels, high LH, or the whole insulin issue. I got a progesterone test after O (normal),a testosterone test pre O (not too high by PCOS standards), and I didn't get false positive OPKs, so I'm really : that this one will stick.

[lifeguard]

What I didn't mention is a actually stopped my my metformin very early in this pregnancy because I was gagging so bad taking it. I'm holding strong at 22 weeks.

[lexbeach]

Thank you all so much for sharing that information with me. Dw had the appointment at the RE yesterday (and insurance does cover it--woo-hoo!), and it went really well. The RE did an ultrasound of her ovaries and said that they actually looked pretty good. She didn't take away the "PCOS" diagnosis, but she did say that the PCOS was super mild. Dw's ovaries looked "active" which means that she might even be ovulating on her own. Apparently she is not a candidate for metformin because she doesn't have any insulin resistance. The plan for now is to do blood work and OPKs this month (today is CD 1), and see what's going on hormonally.

Does anyone know what good numbers are and what hormone levels they'll be looking for? She's going to have bloodwork done on CD 3 and then again a week post ovulation (assuming a positive OPK).

Thanks!

Lex