PCOS question

JenniatONU · December 2011

I have not been able to chart my cycles, but have used OPKS. (When we started TTC I forgot often, then I said screw it, and then this cycle.... my puppy ate the thermometer!)

I have for the most part regular cycles. I've had some longer ones (40 days) but most of the time it's 30 days. When I've used OPK's and had positives, I've had my period 2 weeks later. I would assume then that I'm ovulating.

I've only had one issue with my cycle, in which I did have a 3 month long cycle. This is what prompted my visit, and my diagnoses of PCOS.

When I saw my OB/GYN she told me my ovaries looked awesome. "The best the office saw all day!" My RE told me my ovaries were consistant with those with PCOS and had had many follicles.

So, that's the back story.

I've read and I've seen people say that if you have PCOS you will most likely need help concieving. Is it because of the ovulation issue? The follicles? If someone with PCOS was still ovulating on their own would they still need an IUI or IVF?

In an update, my DH and I are meeting with a new RE in January, and are aiming for an IUI in March. We'll see what the new RE says!

Blueyed228 · December 2011

I am anovulatory with my PCOS so my situation is a bit different than yours. I tried OPK and never got a smiley face (or a period for that matter) IUI was a good first step for us because of MFI issues as well. That is why we needed help.

Has your H had a SA?

JenniatONU · December 2011

Yes, he has. I forget now what the numbers were, I can look back though.

Basically his count was normal, his motility was about 50%, which is low/normal, and his morphology was 40%(not using the strict scale.)

I was just wondering what it was exactly about PCOS that makes women have difficulty getting pregant. We're looking into another SA, and another RE since our last one was very pushy on IVF. (He basically told us he won't do IUI and I should stop trying to get pregnant until we are ready for IVF.) We're in the mindset of doing IUI because of the PCOS with his morphology, unless the next SA comes back to be miraculously amazing.

Blueyed228 · December 2011

My RE usually wont do an IUI unless there are MFI issues. He says for PCOS and a normal SA, IVF is the best option.

Otherwise he just advises OPK's and TI.

ashleymarie512 · December 2011

I'm also anovulatory with PCOS. Long story short--went off the pill in June, had a period in July, nothing until Provera to jump start a cycle in September. I was doing OPK's and then went to the office to do blood test to check for ovulation. I got a positive OPK on CD20 and was scheduled to go into the office on CD21 for the blood work. I was elated!! Unfortunately, my progesterone level was only 1.4 which means I actually didn't ovulate. Talk about depressing! She recommended Clomid when we're actually ready to start trying. We're hoping to start that within the next month or so....waiting for new insurance to kick in. My NP said that IUI would be the next step if Clomid doesn't work. I made some comment about IVF and she reassured me that there were other things to try before IVF was necessary, which was a relief to hear. Husband has low morph (good count/motility) but we're doing a re-test with the new ins.

As far as what actually causes trouble with conception (to my understanding) is the follicles and them preventing ovulation. I think the follicles develop and instead of popping off and producing eggs, they just sit there. I'm super confused why my OPK came back positive but the blood test came back negative.

Anyway, sorry if I'm rambling. I'm new to the board and just decided to start speaking up. I've been struggling on my own and realized I need an outlet....family/friends just don't get it.

JenniatONU · December 2011

Blueyed228:

My RE usually wont do an IUI unless there are MFI issues. He says for PCOS and a normal SA, IVF is the best option.

Otherwise he just advises OPK's and TI.

This just seems to backwards to me! haha. Especially because of the cost difference. If the cheaper way is better for those with more than one issue, why wouldn't it also be the first step for those with one issue? This is why IUI and IVF confuses me. Embarrassed

CousinVicki · December 2011

PCOS normally causes ovulation problems, though i do ovulate on occasion, sometimes for a few months at a time, but then i will have a long cycle and show no signs of it. Also, PCOS can possibly cause false opks and can definitely cause ewcm when you are not ovulating. you should definitely try temping too to get a better idea . i had flat temps sometimes, even with a shorter cycle. all that being said, we conceived our first son naturally during a time of shorter cycles for me, so i was clearly ovulating on my own. now we are back to a RE because of my age and not wanting to take a gamble of wait and see if i ovulate each month or not.

Blueyed228 · December 2011

JenniatONU:
Blueyed228:

My RE usually wont do an IUI unless there are MFI issues. He says for PCOS and a normal SA, IVF is the best option.

Otherwise he just advises OPK's and TI.

This just seems to backwards to me! haha. Especially because of the cost difference. If the cheaper way is better for those with more than one issue, why wouldn't it also be the first step for those with one issue? This is why IUI and IVF confuses me.

Im not entirely sure, but I *think* its because there isnt statistically much of a difference in sucess rates between IUI and TI if there is no MFI issue. I could be wrong though. I remember reading a bit on it and that was what I remember coming away from it with.

JenniatONU · December 2011

Blueyed228:
JenniatONU:
Blueyed228:

My RE usually wont do an IUI unless there are MFI issues. He says for PCOS and a normal SA, IVF is the best option.

Otherwise he just advises OPK's and TI.

This just seems to backwards to me! haha. Especially because of the cost difference. If the cheaper way is better for those with more than one issue, why wouldn't it also be the first step for those with one issue? This is why IUI and IVF confuses me.

Im not entirely sure, but I *think* its because there isnt statistically much of a difference in sucess rates between IUI and TI if there is no MFI issue. I could be wrong though. I remember reading a bit on it and that was what I remember coming away from it with.

And that makes sense. Thank you.

To the other poster: I'm planning on it, at the start of the next cycle! I was doing well this cycle with remembering, but when the pups got it.... Angry

This board is easier to get answers from than google tonight. I like it!

Blueyed228 · December 2011

The thing is that everyones situation and dx is so different that its hard to say whats best for someone else. For me, its why trusting my RE is so important.

annabelle8101 · December 2011

BBT charts are great things. I took mine to my RE consult and he was able to get info from them! The doc said that my temperature rise was too gradual and not enough of a spike. I'm charting with clomid this cycle, so I am excited to see any differences. <- data nerd

psubride1012 · December 2011

Blueyed228:
The thing is that everyones situation and dx is so different that its hard to say whats best for someone else. For me, its why trusting my RE is so important.

Hope you don't mind me answering, but I agree with Blueyed on this one. PCOS is a syndrome, which means it has varying levels of severity and is different for each woman. Some women ovulate on their own and some do not ovulate at all. For me, I was averaging 42 day cycles prior to going on clomid. So I was ovulating, but it wasn't until CD30 or so. So that is what makes it harder to get pregnant on your own - if you aren't temping or using OPKs, you don't know when you are ovulating and makes it harder to time intercourse. The other thing that you should find out is if you are insulin resistant or not. If you are, you can try Metformin, which may help to regulate your cycles.

Both of my pregnancies (my m/c and this pregnancy) happened on our own - no medical intervention. So it is possible. However, I was on clomid for some time before this pregnancy (I had been on a clomid break while we saw a uro) and think it may have still been in my system on my successful cycle. H had some sperm issues, but we were lucky to get them cleared up with the help of a uro. Otherwise, we were planning to do clomid and IUI next cycle. So assuming that your H doesn't have sperm issues, there's no reason you can't try clomid to help regulate your cycles (definitely make sure you're being monitored!) and some timed intercourse before you go down the IUI/IVF route.

So I would definitely see a RE at this point since you have a PCOS diagnosis, if you haven't already. They are best equipped to give you advice and help you get pregnant. Good luck!

ClaudiaStar21 · December 2011

I got positive opks but the bloodwork said I wasnt ovulating. I think you can have a surge but not enough to release the egg sometimes. Also I read that the quality of the egg released might not be good if your hormone levels were irregular during a particular cycle which can also make it hard to get pregnant.

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