Just diagnosed with Lean PCOS and trying to conceive..

KatieDoodle25 · January 2013

Hi there,

I was recently diagnosed with Lean PCOS and am trying to understand my treatment options. Right now, my OB/GYN is starting me on Metformin. I am waiting for my next appointment to discuss treatment further, but I am assuming I will also need clomid to help me ovulate( I am not currently doing so).

Has anyone out there had a similar diagnosis and how are you working through it? I feel really confused and it only gets worse when I try to find out information on the condition. Most of the articles I have read pertain to people for have significant weight gain with the condition. I have not experienced this, so I am just confused and a little scared about the whole diagnosis.

Any help would be very appreciated!

Katie

PurplePanda2 · January 2013

Hi and welcome to the board. I also have been diagnosed with lean PCOS and annovulation . I do not have to take Metformin though, but I have done several rounds of Clomid that has helped me ovulate.

One thing to know is that Clomid should only be taken if proper monitoring is done (blood work/ultrasound at CD3 then again around CD12 to measure follicles as well as 7dpo bw). Many times this type of monitoring is not provided by OB/GYN's, which could be detrimental to your reproductive health. You should also have an HSG and a SA for your husband before taking Clomid.

Most women on here see an RE (reproductive endocrinilogist) because they are true infertility specialists.

I would encourage you to stick around and read the posts on here and you will learn a lot of very helpful information.

ufsandra85 · January 2013

dumb question. what is lean pcos. i have pcos but i have never heard of lean pcos

PurplePanda2 · January 2013

I also have a PCOS question, actually. Is metformin related to insulin resistance? So normally do people with lean PCOS not need metformin because they are not insulin resistant?

KatieDoodle25 · January 2013

When I did my blood work to test for the hormones associated ovary function and male hormones, I remember seeing the DHEAS test. So, I want to say they did test for the adrenal hyperplasia too. The OB/GYN's nurse called to tell me yesterday about the elevated male hormone's and metformin. I have tons of questions for the doctor, so I hope the call with a follow up appointment soon. I also have cystic ovaries, does that occur with adrenal hyperplasia too?

KatieDoodle25 · January 2013

Thank you for replying! Do you work with a reproductive endocrinologist? If so, did your OB/GYN refer you to one?

lobosabby · January 2013

Welcome to the board!

I don't have much to offer from the PCOS stance, but this board is a wonderful rescource and you will learn lots from these extremely knowledgeable ladies. GL to you!

KatieDoodle25 · January 2013

Thank you so much! I appreciate the support! It helps take away some of the scariness! :

KatieDoodle25 · January 2013

I will double check with the doctor when I visit. Better to ask, than move to an ineffective treatment option. Thank you for the info!

KatieDoodle25 · January 2013

Thank you for sharing! Some of my doctor visit bills have made me cringe too. However, I am trying to think positive.

I think I will ask about an RE, couldn't hurt.

Good luck to everyone who has replied, I hope something positive happens for each of you!

ufsandra85 · January 2013

IntuitiveBlue:
ufsandra85:
dumb question. what is lean pcos. i have pcos but i have never heard of lean pcos
Lean PCOS is PCOS when you're not overweight. Some refer to it as Non-IR PCOS (non insulin resistant).

Thanks! I guess that is what I have then cause i am not overweight and 125 lbs I had just never heard of that and i have seen 4 REs!

Shortie24 · January 2013

IntuitiveBlue:
Sorry about your diagnosis. Do you know what criteria your doctor based the diagnosis on? I ask because there are other conditions (like mine - adrenal hyperplasia) that can mimic PCOS. It is especially important to rule out adrenal hyperplasia in cases of lean PCOS because the symptoms are very, very similar. All it takes is a blood test of DHEA-S. If your level is high, then you know it's your adrenal glands, and not your ovaries, that are producing your excess male hormones. The treatment for these two conditions is very different, so it's really important to make sure that you get the proper diagnosis.
That said, PCOS is not an automatic infertility diagnosis. There are plenty of women who conceive spontaneously (without treatment) with PCOS. Others require ovulation inducing medication, like Clomid or Femara. Do you know if you ovulate on your own? If you don't know the answer, then you should hang out on TTGP and learn to chart.
Good luck!

This has me thinking now. I was dx PCOS, but never had cystic ovaries but I have all the symptoms. At first I was thinking Cushing's, since it also mimics PCOS. I have an appt with an Endo in Feb to rule this out.

When could a person get tested for DHEA-S? Could they add it to 7DPO b/w?

imohudson · January 2013

Thank all you ladies for replying to this. I have learned a ton reading this tread. I also have lean PCOS and have been ttc for 2 years. I did the metformin and clomid to no avail. I have recently started taking shots in the hopes of forcing my body to ovulate. My OB told me that lean PCOS is harder to conceive with as there is not easy fix. We are hoping to see ovulation for the first time in a couple of weeks. All I can say is everything I have put my body through and the emotional roller coaster will be well worth it if I get an angel in the end.

Katie, keep you head up and don't fear PCOS. We can all beat it.

KatieDoodle25 · February 2013

Hey there! I have another question for you ladies. Are you using OPK kits from the drugstore or just charting temperature? My doctor asked me to do the OPK kits and I am just not sure I am doing it right. Are there any resources out there that anyone has found to be helpful?

ufsandra85 · February 2013

i used to do charting but now almost all of my cycles are medicated with monitoring. i like charting a lot though and even though my cycles were long i was usually right

ballygirl · February 2013

Hi

I also have Lean PCOS. We tried to conceive for over 2 years before we had success. I was very confused too because my blood glucose levels were ok, so it didn't seem like insulin resistance was my problem, although I am pretty sensitive to changes in blood sugar (huge sugar highs and crashes if I don't eat well). To make a long story short - Metformin was what finally worked for us.

We tried Clomid first with my regular OBGYN for about 7 months and nothing. (I found out later that Clomid is often problematic with folks like us). I then went to an RE and we did several IUI cycles. I always produced plenty of eggs, they just wouldn't implant or they weren't viable. We did 3 IVF cycles and the same thing happend - plenty of eggs but the embryos weren't that great, kind of slow and small and not viable. Finally they put me on Metformin in September. It takes about 3 months for it to really kick in. The reason for this (to my knowledge) is that the eggs in the ovaries are sort of bathed in hormones for several months before becoming active and if the hormonal ratio is off, it can make the eggs less viable. Our 3rd IVF cycle was during the 4th month of Metformin and the results were drastically better. We got 5 really good looking blastocycts. It was still unsuccessful but we were encouraged because everything looked so much better and we had 3 left over to freeze. (My RE said that sometimes the inflamation after a fresh IVF cycle can cause problems with implantation and that thaw cycles are easier on the system) We took a cycle off before trying our frozen embryos and we ended up getting preganant on our own! I just found out last week! We were so shocked. I feel pretty sure that the Metformin has controlled the hormonal imbalance that was causing the poor quality eggs and that allowed us to do it the old fashioned way.

I wish now that I had been put on metformin in the beginning as I feel it would have saved about 2 years of difficult fertility treatments. I think they hesitated to put me on it because I don't exhibit a lot of the typical insulin-resistance symptoms.

Anyway - good luck with it. Metformin is a rough drug on the system for about the first month or so but keep with it. The side effects were gross (diarrhea) and I had to start eating a little differently. Several times I woke up in the morning in a pretty scary and severe hypoglycemic state so I had to start eating protein before bed (glass of milk usually did it) to prevent that. But after a couple months, my body adjusted and now I have no problems unless I forget to take the pill for a day.

Starbinks · February 2013

PurplePanda2:
I also have a PCOS question, actually. Is metformin related to insulin resistance? So normally do people with lean PCOS not need metformin because they are not insulin resistant?

That is correct. From what I understand metformin can be used in the treatment of diabetes as well. I have lean PCOS and I do not take metformin. Just Clomid and an ovidrel shot seem to be working for me.

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