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Infertility
mpayne
member
Frustrated & On the verge of crying- PLEASE HELP
mpayne
member
in Infertility
Good Morning Gals,
I will give my apology to all of you now, since this will be a long post but I need to vent and get feedback so please feel free to share your thoughts. Today is one of those days when you know it's not going to be a good day. I have been really tired lately so I took a pg test to make sure I wasn't prego and I'm not. I have a sister who lives in Germany and is almost 7 years older than me. We have never really gotten along but she came home to visit with her two kids. I asked her about a month ago to give me some background info on how long it took her to get prego if she had something similar to PCOS, which my gyno thinks I might have b/c my testosterone and pretestosterone levels are double where they should be. She told me we'd talk when she got home and today's been a week since she's been in the US, and still nothing. She's known for over a month that my appt is today at 3:15 PM and I went to my mom's house, where she and the kids and her hubby will be home tonight are staying. I dropped stuff off an one thing led to another and I told her about my appt. and how my gyno thinks I should go on Chlomid. She thinks it's too soon and then she started going off on me about how I've only been off the pill since Jan and how I have to give it time, yet in the same sentence she said she got prego in 4 months. Hello I am going on 6 months. I realize you should wait a year before starting fertility drugs but at the same time I'm frustated b/c I really wanted to be prego by the time I'm 30 and I just turned 29 in May.
Secondly, My sister said she didn't want to talk about her struggles via e-mail b/c she had a miscarriage before her daughter who is now 3. I can't say I know what that feels like b/c I don't but HENCE the reason why I am asking for my sister to tell me what she went through so I can also let my doc know incase I go through something similar. Therefore, she told me she went on something similar to Povera but it lasted two months, rather than povera which lasts 10 days (or at least it did for me). So, she took it for two months and then she went to see her gyno and told her she hadn't received her period adn that the stupid medicine wasn't working but that's when they found out she was prego and then two weeks later when her hubby went with her realized she had miscarried and she ended up having a DNC and the whole nine yards. Anyway, She has always had bad acne problems for as long as I can remember and then I started to have bad acne problems after getting off the pill and especially after taking povera. So, I guess what I am trying to say and ask is what would you all do in my situation? I am seeing my gyno today. My hubby is going with me b/c he's a great guy and b/c I need the support. We said we wouldn't "try" to get prego until Sept but I'm antsy. The reason we said Sept. is because his truck will be paid off along with a few other minor bills. However, we both said that if it happened before then we'd be ok with it. I just want to know if I can have kids or not. We plan to take a cruise in Oct. so I guess if I'm not prego by then I'll start chlomid but what happens if Chlomid doesn't work, then what? Then I've wasted these few months in between (June-Oct). so I don't know what to do. Please help. I apologize for the long post but I could really use your feedback by today.
This discussion has been closed.
Re: Frustrated & On the verge of crying- PLEASE HELP
Take a deep breath.
At this point, you are not infertile.
If you are under 35 years of age, most doctors want you to try for 12 months. Over 35, 6 months.
Then you typically get bloodwork done on the 3rd day of your cycle, an HSG (to make sure your tubes aren't blocked) and your DH a semen analysis.
After those results, your ob/gyn or RE would make a recommendation for treatment.
Do not just take Clomid without getting those test first. Don't waste time taking medicine when the problem could be something else - like blocked tubes or zero sperm.
As for your sister, I wouldn't worry about it. My mother and 2 older sisters had no problems getting pregnant, but I do. It is just they way it is.
Good luck.
I do understand how it feels to be worried you will be "wasting" time, but you really should be working on getting a complete work up regarding your fertility. We started the work up after trying for 5 months because of my history of endometriosis. I felt very similar to you-worried about what would work and what wouldn't work, and wanting a plan.
I started seeing a RE who did a complete word up-day 3 blood work, ultrasound, HSG, and a S/A. We were glad that we did-because we found out that DH's S/A was extremely low, and that in no way would we be able to conceive on our own. I'm glad we started the testing earlier rather than later.
DH's B and SIL are also going through IF, and my BIL told DH to wait until a year, and we are really glad we didn't take their advice!
I know it's hard not to be freaking out, and everybody hates the "relax", but there does become a time where you will drive yourself crazy if you don't.
Do you have IF coverage? I'd call your insurance and find out the specific of coverage, when and how they would cover it, etc. That will make a huge difference. There are things you can do now-are you charting? Using OPKs?
TTC #1 Since 3/2010 Diagnosed with POF
6/2010-IVF #1 Cancelled after ER b/c 0 eggs recovered
On to Donor Eggs
9-30-10 IVF w/ DE begins & Donor started stims 10-4-10
Donor ER 10-14-10 14 Fertilized Eggs ~ ET 10-17-10 (7 Frosties)
IVF #1 11-18-10 M/C @ 7 Weeks~Stopped growing @ 5 Weeks
FET #1 2-1-2011
Beta #1 13dp3dt 2-14-2011~722
Beta #2 15dp3dt 2-16-2011~1942
1st U/S 3-3-2011~Twin Girls
This!
It sounds like you really are jumping the gun a bit here. You're letting your actions be motivated by fear. It IS scary to think that you might not ever be able to have kids. But at this point there is no reason to believe that is the case. If you really think you might have PCOS then get the day 3 and 7 dpo blood testing done. If your diagnosis is confirmed, your doc *might* put you on Clomid even though you haven't been TTC for 12 months yet. However, generally it's a good idea to have an HSG and an S/A before you start medicating. Those tests cost $$$. Also, I will say from experience that Clomid blows monkey balls and that isn't a train you want to hop on unless you have to...
I understand your fears and concerns but as pp have said, if you're under the age of 35 then it can take up to a year to become pg and that's completely normal. Frustrating, yes, but absolutely normal. Most of us on this board have been TTC for years. If you're over the age of 35, then they recommend seeking medical attention if you haven't become pg 6 months after TTC. Some people aren't as comfortable discussing their fertility as some other people are.
I agree with pp that you need a further work up before taking Clomid. Your DH needs a semen analysis and you need an HSG. Any responsible physician would do a further work-up on you before having you start Clomid. No amount of Clomid that you take can fix blocked fallopian tubes or fix any potential infertility issues that your DH may have. Clomid can lead to ovarian cysts and causes horrible side effects and you need to be properly monitored while on it (bloodwork and ultrasounds). OBGYNs hand out Clomid prescriptions like it's candy and don't provide proper monitoring.
GL with your next step.
First, I think you have to let go of the idea that you think you have to be pregnant by the time you are 30. Life just doesn't work that way. It takes a normal couple 6-12 months to get pregnant.
Even if you do have PCOS, that doesn't necessarily mean that you won't be able to get pregnant on your own. My SIL has PCOS, and she has two little girls with my BIL without fertility treatments.
I would go to your OB appointment. But I would not take Clomid with your OB without further testing. Also, you want to make sure that you get proper monitoring while on Clomid. (This should include blood work and ultrasounds.)
Unexplained Infertility
After two Clomid cycles, three injectable IUI cycles, two IVFs, two miscarriages, and one lap surgery, IVF #2 has brought us our little boy!
TTC #2
After months of being postponed or cancelled, FET #1.3 (Natural FET) brought us twin girls!
Ok Ladies! I am trying to take deep breaths. First let me say thank you for the feedback I have received thus far from all of you. I really appreciate it. Secondly, The only tests I have had so far have been a thyroid and whatever else is included in that test as well as a hormone test. With that being said, I have no idea what the following tests are that you have written about. What is DPO testing on the 3rd & 7th day???? I got off bc on Jan. 4th, got my period Feb. 1st and then nothing until I took Povera. I started taking Povera on 5/19/10 and had my period on the 10th day exactly (5/28/10).
I have no idea what HSG & S/A is??? I know one of you gals said about getting the HSG taken on your 3rd day of a cylce but once again what if I don't get a cycle? I haven't had AF since the 28th of May when I got it and it lasted the normal 5-7 days. It was more like 5 days and then I wore a pantyliner for 2 days.
I have not started charting my temps b/c this was going to be something I brought up to my gyno today. However, I have been keeping track of when I have my period, when we have sex, etc... just in case. I have not taken any OPK's b/c I was told with PCOS and taking Povera that the OPK's will not work. Is this not true? However, even though I did not try the OPK's we did have sex around the days that you are normally fertile on a 28 day cycle.
I am just tired of every one of our friends making it look so easy to have a baby. We had 12 friends between the 2 of us have babies last year and I want to scream. How is it so easy for them? At this point, I would love to go back to school and talk to my health teacher about how you can have unprotected sex and not get prego.
Anyway, feel free to keep posting your comments. Thanks for all of your help and feedback, I am writing these suggestions down and is something I plan to discuss today.
DPO - Days past ovulation
HSG - It is dye test that is done to see if your tubes are blocked and check your uterus.
SA - Semen analysis
Typical work up of fertility issues - you get bloodwork done of cycle day 3 to test for various things. Then you get an HSG done (I did mine on the same day). And your hubby gets a SA.
Then the doctor looks at all of those things to make a prognosis and treatment plan.
We understand your frustration. Since you have a doctor appointment, I would ask for these tests. I don't have any advice about not getting AF.
Good luck.
Cycle day 3 blood work is done three days after you get your period - the following are usually tested: Insulin, Follicle Stimulating Hormone, Leutenizing Hormone, Prolactin, Thyroid Stimulating Hormone, Testosterone, Sex Hormone Binding Globulin, Albumin, Estrodiol.
HSG = Hydrosalpingogram - they shoot radioactive dye into your utuerus and through your tubes to confirm that your tubes are open
S/A = semen analysis
7dpo = 7 days past ovulation - this is when your Progesterone level needs to be tested
My clinic (as well as I'm sure others!) have sections that include information on fertility, infertility, and how and when to get started. It helped me immensely to read up on the steps and gather information, that way I could ask my gyn or RE specific questions as well as give specific answers. If you'd like the link to my clinic I'd be happy to post it!
First of all, your sister's IF problems have nothing to do with you..meaning just b/c she had PCOS and M/C's doesn't mean you will.
Personally, I'd be kind of upset if I was your sister. You said you're not that close, she's visiting - sounds like you've been hounding her to divulge her IF with you which then she had to share with you she went through a M/C- and I'm sure she doesn't want to relive those emotions. I hope you've been sympathetic and apologized to your sister.
Anyways - calm down. Why do you think you have PCOS? Just b/c you have acne and haven't had your period since stopping BCP less than 6 mos ago? That doesn't=PCOS. Even if you do have PCOS- you can get pg. Your hormone levels were checked by your gyn- what cycle day were they done on? Part of a basic IF workup involves bldwk/US on CD3 (cycle day 3) and 7 dpo (days past ovulation). Also, pretty sure you need more testing than just one hormone level check to dx PCOS. If your gyn suspects an IF issue, he needs to do further testing and really, testing should be done by an RE.
You went off BCP in January- it can take months for your body to regulate itself again- your lack of period may be d/t your body coming off of BCP.
2nd- timeline goals- like I want to be pg by the time I'm 30 need to be thrown out the window now. Why 30? What's the significance in that? You cannot control when/if you get pg- so don't hang all your hopes on this timeline. Let's see... I remember a long time ago I thought it'd be nice to be pg by the time I was 30. That was 3 yrs ago, I'm now 31.
3rd- yes, people you know may be getting pg all the time, easily . Some of these people also may have suffered IF,gone through treatments, not announced when they started trying- so maybe they've been trying for a loong time.... some may have just started trying and gotten pg the first try. Some may never be able to get pg. That's life. Everyone is different. You can't spend your life comparing yourself to others. It's not a competition.
Yes, it is painful to see others get pg so easily- believe me, I know. Everyone on this board knows. Many of us have been trying for years and in that time we've been lapped quite a bit by friends/family. Many of us are seeing our friends delivering their 2nd or 3rd child and we still are trying for our first.
Finally, make an appt. w/ your gyn. Don't assume you are IF. It is good to be proactive and have this in the back of your mind maybe- but unless you have a dx IF disorder, an RE isn't going to see you unless you've been trying for at least a year if you are under the age of 35.
Also- don't just take clomid. You have no clue what is wrong with you, if anything. If your Dr. recs clomid without going through a basic IF workup, then get a new dr. You also need to know the risks of clomid.
If it ends up that you still have problems, no AF and have been to your gyn - they can probably do some basic bldwork-
Before you start ANY IF treatments- you need to be seen by an RE (repro. endocrinologist)- you need baseline testing, HSG (hysterosalpingogram), your husband needs a SA.
I suggest reading Taking Charge of Your Fertility. Have you charted?
I really hope you don't have IF, but if in the future, you find out that you do, then keep this board in mind.
Hopefully I didn't come across as too harsh but oh well- I'm just thinking how your sister must be feeling as a fellow IFer. And I'd be really upset if a close family member who I haven't seen in forever expected me to go over my IF issues and was upset that I hadn't done so after a mere week of visiting. I actually would say it's none of your business, but that's just me. It seems to me you're interested in all of this b/c of your fears that it may affect you since you MAY have an IF problem. I can only hope that you were interested in this when your sister needed your support going through IF.
of course, I know nothing about this- and this may all be a moot point- you may have been your sister's biggest cheerleader, you may have not known about it b/c she didn't tell you... so you may disregard this if that's the case.
Thank you ladies for all of your help. Please feel free to keep posting. I will tell my gyno that I don't want to start taking Chlomid yet. I will try to wait until after our much needed vacation in Oct/Nov to see the doctor about getting on a fertility drug if I am not prego at that point in time. I will also ask for these tests that you are all talking about but my only problem is that now I'm almost a month past since I stopped having AF. I started AF on 5/28 and ended on 6/3. So, I can't get some of these important tests done since I don't have AF anymore and I don't know when/If she will return... lol.
I am also having horribe acne, maybe since they know my hubby is coming along they will do a SA on him. Also, I think my gyno ran all of the hormone tests on me already b/c everything looked fine except that I had double the testostosterone and pre-testosterone than normal. However, with the few short seconds this morning, before my sister and I fought, she said her test and pre-test were also high but didn't know how high. So, who knows? I will wait to see what the gyno says and I will def not take chlomid until these otehr tests are run and until I have given the TTC a few more months. Thank you so much ladies, it really is great to have people like all of you to lend a helping hand and make everything seem a little better. I can't thank you enough.
My only problem is that I feel like I'm playing russian roulette b/c I never know when/if I'm fertile since I don't get AF. So, how will I know when I'm fertile? If I start charting my temps, will it tell me when I'm fertile even when I don't get AF?
I'm real sure your sister would love that you are telling everyone about her acne/ IF/ and MC's on an internet board.
My first impression of you is that you seem selfish and impatient. Calm down. Be supportive.
Thank you for your feedback but my sister and I have never gotten along. I only told you and the board of snipet of what our life together is like. She said she would tell me everything before my appt b/c she wanted me to know. I didn't push her. I told her I didn't have to know everything but she chose to tell me and then when it came to today being the appt. all of a sudden it was different. I would apologize if I felt like I did something wrong but I haven't. I think she shouldn't have said I will tell you what happened so it helps you and so if something happens your gyno can have a heads up that it's normal and that she (my sister) has also gone through it. I should have known better though b/c the only thing she cares about is herself and she also has to be the center of attention. Hence the reason why she couldn't come home for our wedding in May of 09 when the airfare prices were cheaper but in middle of June of this year when the airfare pricing is more expensive and she now has to pay 1/2 for another child, why not fly home for June and while she's at it turn around and come home again Dec. HMMMM Oh that's right she couldn't come home for her little sister's wedding in May b/c that would mean she wouldn't get the attention.
She lives in Germany so I tried to be as supportive of everything she's been through as much as I could be but she didn't tell anyone, except her hubby, so How supportive can I really be??? I can only do so much and the last time I checked I'm not a mind reader...
As far as why I think I have PCOS is b/c I have had the numerous hormone tests as well as an ultrasound stating it couldn't be ruled out. My gyno told me he was leaning towards it b/c of my blood work results and b/c of my not getting AF. Therefore, I am going by what I am told. However, NONE of my tests were done when I had AF. The last time I was at the gyno was May 19th and that night I started taking the Povera. I haven't been back since... not even when I had AF.
As for our friends, I know all 12 of them had no problem TTC and all got pg within 3 months of trying. I'm not saying I have to be like them but rather I am saying it sucks b/c I wish some people didn't take it for granted. That's all I'm saying. I don't mean the people on the board but rather our friends. Some of them act like it's really easy to get pg and they don't understand why I'm not.
When you said about hopefully you didn't come across as too harsh, but oh well. That's how I feel too, I have broad shoulders and can take it. However, you don't know the half about my sister so you shouldn't feel sorry for her. She never went through any fertility drugs or IF for that matter. She got prego like that, so if anything I should feel bad for what you and others on the board have gone through but I don't b/c I'm sure you girls wouldn't want self pity and like you said "That's life. Everyone is different." However, I don't look at this as a compeitition I look at it as if my DH and I want to have 2-3 kids then I should start looking at all of the possiblities since I don't want to be in my 40's TTC b/c then you are more likely to have complications and problems with the baby. It's not a matter of competing but rather it's a matter of knowing IF I am capable of conceiving. Anyway, thanks for the advice, I hope I don't come across as bitchy but if I do, Oh well.
So, let me get this straight. No one should feel sad for your sister miscarrying a child because we don't know her and she wasn't IF.
It's called compassion and it's not limited to only people you like, know well, or who are infertile.
I think you are worried too much about your sister's diagnosis or problems. I don't think it is that important for your diagnosis. It sucks that she isn't being more helpful, but I don't think it is going to hinder any treatment you receive.
As for all of your fertile friends - 80% of healthy couples get pregnant within the first year of trying. They are on the lucky side of the odds and got pregnant quickly. 3 months of trying and getting pregnant is not the norm.
Agreed.
"Smudge's Story - How to Grow a Dandelion" will return soon!
The Dandelion Archive
"If dandelions were hard to grow, they would be most welcome on any lawn."
Thank you for everyone's help and advice.
www.shadygrovefertility.com
Tonight they have a webinar on getting started, and tomorrow is a webinar on PCOS.
Check the "Getting Started" section on the main page for more information on: Understanding Infertility, When to Start Treatment, and What to Expect.
Hope this helps.
I understand how frustrating ttc is, and I know how easy it can be to get false ideas from your friends. I had two friends who announced that they got pregnant on their first try - not just their first cycle, just their first encounter - due to the husband's "super sperm." Actually, they both used those exact terms. While other people were trying to eat. I also had unrealistic expectations of how long it would take due to the fact that people who were trying longer stayed quiet about it and did not broadcast their difficulties to the world.
But the bottom line is that you are 29 years old, and went off birth control 6 months ago. That means that it is entirely possible that your body did not begin to ovulate normally for 2-3 months. So you may have only had a reasonable chance of conceiving for the last 3 months. I know this information doesn't make the wait any less frustrating, but it does point to the significant chance that there is nothing wrong with you, and that you will be able to conceive naturally within a year.
If you are anxious, you can certainly visit a RE (reproductive endocrinologist) who can order tests to check your fertility and your partner's fertility. But without a diagnosis of infertility or trying for at least a year at the age of 29, I would be very concerned about taking Clomid. You are more likely to become pregnant with multiples, which carries higher risks for both mother and child. I don't think that risk is worth taking until it is medically certain that you have infertility.
But since stress is very closely linked to fertility, you may also want to look into yoga or acupuncture to help you relax.
Hey, hope it's ok that I'm posting here. It just seems like a lot of what's being said is going over the OP's head, so I wanted to make sure she's clear on the basics.
OP - I have a pretty similar situation to you. I came off BCP in Feb 2008. When I hadn't gotten a period by May 2008, I went to see my OB/GYN. We discussed my history (late onset of menses, very few "natural" periods) and she said that based on my history, she'd be comfortable diagnosing PCOS. To follow-up, we did bloodwork.
What they generally look for in a PCOS bloodwork diagnosis is the LH to FSH ratio. Those are two different hormones that are key in growing mature follicles and triggering ovulation. The ratio of these hormones is usually 1:1, but it can be very skewed in women with PCOS. Another way to diagnose PCOS is through an ultrasound, which will show many, many large follicles in the ovaries - in a normal ovary, you start out with several small follicles and one grows until it is mature, then it is ovulated. Both the bloodwork and ultrasound must be done on the 2nd-4th day after your period starts (generally, it'll be done on day 3) to be accurate.
I know you are concerned with your period not coming, and therefore not being able to do these tests...don't be! You will simply have to take the Provera again in order to jump start your period and get the testing done.
Unfortunately, if you are not getting your period, you can be certain you are not ovulating. However, this doesn't necessarily mean you have PCOS, or are infertile. You may just need more time coming off the pill. Regardless, you do need to have a period at least every 3 months. If you don't get one on your own every 3 months, you need to induce it with Provera. Not having a period at least every 3 months can increase your risk of cancer.
I can't tell you what you should do, that is for you and your DH to decide, but I can tell you what we did. After 3 months without a period, I went to the ob/gyn for testing. She diagnosed PCOS and gave me Metformin (drug that helps to regulate blood sugar levels, also critical in infertility in PCOS patients). Metformin takes 3-6 months to reach its full working potential in your system, so after 6 months of being on the Metformin with no results, I went to the RE. The RE confirmed the PCOS diagnosis and we tried Clomid, which didn't work, and injectible medicines, which did.
I agree with the PP who suggested reading Taking Charge of Your Fertility. Personally, charting was a waste of time since nothing ever happened, but if you read the book, you will know what signs to look for that indicate ovulation may be occurring and you'll be able to TTC then. If you aren't actually taking your temperature every day, you won't be able to confirm ovulation, though. GL!
SLPMEL: Thank you for the link last night. I signed up for the two webinars but I never received the necessary information so I could join in on the discussion. Therefore, I missed the event last night but I did sign up for the PCOS tonight, however I still have not received anything. I sent an e-mail to Marcelina Davis who is the "Ask the Expert" but I received an out of office reply stating the following, "Thank you for your email. I will be out of the office on Thu 6/24-Mon 6/28 returning on Tues 6/29. I will not have access to my email or voicemail. I will respond to you upon my return. If you need cancel or reschedule your appointment or need immediate assistance please contact one of our patient liaisons at 1-888-761-1967. Have a great day!!!! Therefore, What should I do? I would love to listen in on this webinar since I am not familiar with PCOS. Your thoughts would be appreciated.
Kit.Kit343: Thank you for all of the information, you are correct with everything you stated. I know I am jumping the gun per say but it's just hard not to. I guess it's just anxiousness. Anyway, I realize I have to be patient but it feels like the time is standing still and is therefore, very frustrating. I have been going to the gym everyday since my hubby and I quit smoking 10 months ago and I have come to find out that it's a great stress reliever, but I would love to do Yoga sometime.
Skypekwith...: WOW You are 110% correct in everything you said. When I was reading your post I realized that everything you said has been done or was discussed. For instance, I never got my period hence the reason why I originally went on the pill. I would only get it once a year but it was always unexpected. Now, that I'm off the bcp my body was resorting back to the way it was prior to the pill. I went from Feb-May before I went to the gyno to tell them I hadn't received a period. Then Povera worked but when my DH and I went to the gyno yesterday he told me they made a mistake. They should have brought me in for some testing (like you discussed in your post) during the time I had AF. However, they didn't do this so now my gyno is hoping my body will form a period on it's own by Mid July but I don't see that happening since I went so long without it but who knows, anything is possible.
I already had the thyroid tests ran as well as an ultrasound. My gyno didn't understand why the lining on my cervix was shredding itself even though I'm not getting AF. So, that was one problem and then he told me yesterday that I have cysts on my ovaries but they aren't anything to worry about. I guess it's normal when you don't get your period. Does this sound right?
My gyno also told me that if I don't get my period, by mid July, that he will put me on Metformin. Then I guess we will see what happens with that and by Oct. or Nov. if I'm still not prego he will put me on Clomid. Does that sound about right? My gyno has not diagnosed with me with PCOS b/c he isn't 100% sure. He wants to wait until I receive my period so he can run the tests that were discussed in PPs before diagnosing me to the insurance company with PCOS. So, I guess we will see what happens.
I def plan to get the book, Taking Charge of your fertility and I am looking forward to educating myself more on all of the issues that have been discussed. I appreciate all of the comments and feedback and I look forward to the waiting game... lol.
Thank you for your support and understanding when it comes to charting my temps (which my gyno told me was a waste of time for me), and he also told me the same thing you said which is that since I'm not getting my period, I am not ovulating, so that makes it very hard for me to get pg. As of now, I need to learn to take a few deep breaths, take one day at a time and be thankful for what I do have. This forum, my DH, my two puppies, etc... I am also looking forward to going on our 10 day cruise in Oct. since it will only be the second time we have gone on vacation in the almost 4 years I have been with my DH. Thanks again to all of you for the helpful feedback.
That all sounds about right for this point in the game. I would say if you're looking for next steps, you should give your OB/GYN a call when it's been about 2.5 months since your last AF and let him know, then ask to come in for testing for PCOS. Induce your period, do the tests, and start the Metformin. DO NOT start the Metformin right before your cruise, it can be really tough on the tummy and you'll probably spend the cruise feeling miserable, it takes 2-3 weeks to start feeling normal again on Met.
Give the Metformin 3-6 months to work - for some PCOS women, just taking Metformin will get them to ovulate. If it doesn't work, start looking into your insurance requirements for seeing an RE. I think most of the girls here would recommend moving to an RE before doing anything further than Metformin. Your OB/GYN can also try Clomid with you, but you need to make sure they're monitoring you with bloodwork and ultrasound while you're on it. Also, you're only supposed to do 6 cycles of Clomid, so it may make more sense to go right to the RE and make sure you're doing it correctly.
I also go to Shady Grove and loved the webinars...they look a little different from how I remember, but you should be able to play them "On Demand" from this page: https://www.shadygrovefertility.com/webcast. You can also browse around under the "Resources" tab for a lot of good info. Looks like my doc is the current featured expert ;-)