Need Advice!! New RE or no?

KMlostek

Hello everyone!  Quick background.  I have PCOS. I have very irregular periods. Have been trying to conceive naturally for over 2 years.  I met with my RE for the first time in December.  Since then I have done one cycle of Clomid (100mg CD 5-9) and one round of Femara (5mg CD 5-9). On Friday, my RE classified me as a low responder to Clomid and Femara.  With my U/S for clomid on CD 13 my follicles were at 10mm and my RE told me I would not ovulate that cycle.  I noticed a couple of obvious ovulation signs around CD 16 and decided to take an OPK (my RE told me they wouldn't be necessary) well it showed positive.  My DH and I decided to try despite what my RE said but we did not get our BFP that cycle.  Also, at my U/S my RE told me that my response to both medications was about the same.  I have decided on my own to not completely dismiss this cycle though because of my +OPK last cycle.  I will be trying Metformin along with the Femara (still 5mg) next cycle.  I am fine with trying that but my main question is...is it odd that my RE is completely dismissing one thing instead of trying an increased dosage since I am a low responder with the dosage I am at now?  Also, if the Met & Femara do not work then we move on to the injectables and he said I would have to lose weight first because I would not respond to it now.  Is that also accurate?  I am feeling very frustrated!

Side note: My RE at EVERY appt brings up that losing weight could be my answer but he isn't trying to "harp" on me about my weight.  I am overweight.  My weight gain started about 6 months after my irregular periods though so I don't feel that losing weight is my only answer.

 I am open to any advice.  The idea of an RE scared me for a long time so I am still fairly new to treatments and trying to learn as much as possible. 

runforcookies

Aside from your concerns with medication... I would say it sounds like you are not comfortable with your current RE and that alone would make me say I encourage you to at least have a consult with another RE. 

Being comfortable and having faith that your RE is doing everything in their power to help you get pregnant, looking out for your best interest and addressing your concerns is HUGE.

Starbinks

I have had 10mm follicles as late as day 15 and still ovulated that cycle. My RE just has me keep coming back for monitoring until something happens. Some people are just slow responders.

KMlostek

You are exactly right!  I think I have been so consumed by the details of the meds that I have ignored the fact that my relationship with my RE isn't really working for me.  

 I think you just forced me into an Aha! moment!  Thank you!

KMlostek

Starbinks:

I have had 10mm follicles as late as day 15 and still ovulated that cycle. My RE just has me keep coming back for monitoring until something happens. Some people are just slow responders.

 My RE has just basically said I am out of the running for that cycle both times.  Even when I told him I had +OPK results for the previous cycle he said that the clomid probably caused a false positive.  I don't love making the 35 min drive to my RE but if I had to do it everyday to see on an U/S that I am indeed ovulating I wouldn't complain.   

katib77

I agree that it's both important to trust your RE's judgement and that there are some that are just late responders.  If you combine those two it's def. time to look for a second opinion.  As for weight, while it can help with some PCOS ladies, and in general...most RE's don't bring it up unless you're morbidly obese.  

Edit to add:  I'm a size 14 and about 40lbs over weight and it was never brought up.  My IRL friend that saw the same RE and had PCOS was a size 18 or 20 when she started treatment, and while it was brought up that it could help with her PCOS she was never told she had to lose weight for treatment.  

KMlostek

Thank you so much for the input ladies!  I knew coming here with my frustrations and for advice was a good decision.  I am calling a new office tomorrow! 

jfb29

I definitely get a second opinion.  I have PCOS and need to lose quite a bit of weight.  After my break (I'm working on losing some - this was me deciding to break though, not my RE) I will be moving onto injects.  I didn't respond to either clomid cycle (haven't done femara) and had 12mm on CD 16 my last cycle.  Nurse said they wouldn't do IUI due to egg quality issues.  CD13 seems a bit early to decide.  GL with whatever you decide!  Sorry you are dealing with this!

ksgsmu

 I am overweight and I  am on full injectibles and I respond every time.  Now I don't have PCOS, so we aren't comparing apples to apples, but that seems odd to me.  I was told if I go forward with IVF in the future I will have to lose some weight first.

pennygwen

I am sorry you are having difficulties with your current RE. If it were me, I would try and find another RE who I felt more comfortable with.

I also have PCOS and was on the heavier side when we first started treatments. I directly asked my first RE if we would be able to do any treatments because of my weight. He said absolutely, that of course you want to be as healthy as you can be, but that there is no reason not to start treatments at the weight I was. We went through multiple Clomid and Injectible cycles with him, while I was on Weight Watchers of my own doing, and I ovulated every time. I am a slow responder as well, but that wasn't a problem for either of us. Now we did take a break to prep for IVF, in order to lose additional weight, but that is pretty common.

I recently started with our second RE. He asked me how much I weighed but again never said that it would hold up any treatments. I told him I was still on a weight loss plan, how much I have lost up until now and that I plan to continue it until I get to my goal weight.

Good luck to you!

KMlostek

At my second appt, my RE mentioned maybe having to move to injectables if clomid and femara did not work but never mentioned anything about my weight then so it makes me wonder how truthful he is being with me.  Definitely time to find someone I am comfortable with!