Trouble TTC

Another Intro & Asking for Input about ?s for RE

Hello ladies.  I did an intro post about a month back and have been lurking ever since.  I have my consultation with a RE on Thursday and am trying to get my list of questions together.  


I am 28, my husband 34 and we have been TTC for 10 months now.  I went to my doctor after not getting a period or BFP for almost 60 days.  After many tests and an ultrasound, she diagnosed with PCOS.  The only observable sign of PCOS I have is irregular cycles.  I am 129 pounds, so normal BMI.  My testosterone levels are crazily high at 114 (high range of normal is 45, according to my ob/gyn), but there are no observable signs of this.  My AMH test reveal that my ovarian reserve is 43 (normal is about 3, according to my ob/gyn).  I am not insulin resistant.  Because of these levels my ob/gyn referred me to a RE.  She said that because of my hormone levels, but I probably won't respond to Clomid right now (but I forget the specific reason for that is).

 

I don’t have to lose any weight, but losing a couple pounds and increasing my muscle mass certainly wouldn’t hurt.  From what I read, diet and exercise can have an impact on PCOS for some people.  I am sure lifestyle changes (diet, exercise, etc) will be part of my RE consultation.  I have also read that spearmint tea and saw palmetto can help reduce the amount of androgens in females.  I will ask the RE about this specifically though.


I am a person who likes to understand things so I want to make sure I ask the RE the right questions.  I will ask about lifestyle changes and the tea and saw palmetto.  Would you ladies be able to share what questions you asked your REs or what might be helpful for me to know?

 

I appreciate anybody’s help and input.  Thank you!

Me: 28  MH:35

Married September 2012. TTC since September 2013

June 2014 - Dx w/ significant PCOS and referred to RE.

July/August 2014 - Testing complete: Testosterone & AMH very high, FSH slightly high, Vitamin D low, tubes and lining all lovely. DH SA: A+

Cycle 1 (Nov 2014): 2.5 mg Letrozole/Ovidrel/TI = BFN

Cycle 2 (Dec 2014): 5 mg Letrozole/Ovidrel/TI - BFN

Cycle 3 (Jan 2015): 5mg Letrozole/Ovidrel/TI - BFN

WTF consult scheduled for 1/29

Re: Another Intro & Asking for Input about ?s for RE

  • No experience with PCOS, but I wanted to wish you good luck- it can be very overwhelming at first. I second the notepad idea- also bring your questions written down; I always forget at least one if I don't!
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  • Thank you, ladies, for your input!  I am definitely bringing a notepad.  I've already got my questions written down:

     

    1. What other tests need to be done before beginning any treatment? (I've already had several done and ob/gyn is forwarding records to RE)
    2. What type of treatment would you use first in my case?
    3. What are success rates, side effects, costs, chances for multiples, chances for miscarriage, amount of monitoring appointments?
    4. What are some lifestyle changes that might affect outcomes? 
    5. Any homeopathic things I can take to affect outcomes?  Spearmint tea, Saw Palmetto, Vitamin D, Pregnitude, etc.?

    If Clomid is recommended, I will ask about Femara vs. Clomid.

     

    Any other ideas? 

     

    Thanks again.  Clearly, I am a list person.

     

    Me: 28  MH:35

    Married September 2012. TTC since September 2013

    June 2014 - Dx w/ significant PCOS and referred to RE.

    July/August 2014 - Testing complete: Testosterone & AMH very high, FSH slightly high, Vitamin D low, tubes and lining all lovely. DH SA: A+

    Cycle 1 (Nov 2014): 2.5 mg Letrozole/Ovidrel/TI = BFN

    Cycle 2 (Dec 2014): 5 mg Letrozole/Ovidrel/TI - BFN

    Cycle 3 (Jan 2015): 5mg Letrozole/Ovidrel/TI - BFN

    WTF consult scheduled for 1/29

  • Before my first treatment cycle I also asked what they would do if I wasn't responding to the medication and at what point they would consider it an over-response and cancel the cycle. I also asked at what point we would re-evaluate our treatment plan. 

    I think you have a pretty good list already though. Good luck!
    **siggy warning**  **everyone welcome**

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    DS- 11.07.02
    DSS- 6.26.04
    Married- 6.29.13
    TTC Again- Sept. 2013
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    Test Results/Diagnosis- HSG & SA totally normal
    DX: 3/2014 Prolactinoma/Hyperprolactinemia- Started cabergoline 2/2014
    5/2014 Possible mild PCOS in addition to hyperprolactinemia??
    7/2014 Adding probable tubal factor to the diagnosis list
    9/2014 And now adding hypothyroid to the list- Started synthroid 9/2014
    Cycles 1-4 - Sept.-March- All Anovulatory 
    IUI #1 March/April-  Clomid 50mg + Clomid 100mg +Trigger + IUI #1 = BFN
     IUI #2 April/May-Clomid 100mg + Clomid 150mg + Trigger + IUI #2 + Endometrin=BFN
    IUI #3- June- Follistim 75iu + Trigger + IUI #3  Benched due to a 40 mm cyst. :-(
    IUI #3- July- Follistim 75iu + Trigger + IUI #3 + Endometrin = BFP! on 7/25/14
    Slowly rising betas - Ectopic suspected on 8/8/14 & confirmed on 8/11/14
    Methotrexate on 8/12/14 -HCG negative on 9/2/14
    IVF #1- November- Antagonist protocol: 11/1: start stims, 200iu of Follistim; 11/12 ER 17R/14M/14F; 11/17 5 day transfer of two blasts, 2 blasts and 2 expanding morulas frozen; 11/22 BFP!! (On FRER at 5dp5dt)
    Betas: 9dp5dt 205, 11dp5dt 497, 14dp5dt 1,709
    u/s at 5w0d- 1 sac; u/s at 6w0d 1 baby with heartbeat, another sac without a heartbeat
    image


  • Welcome! That looks like a great list! Can't offer any advice on the PCOS but wanted to wish you good luck and hope they get a good plan set for you :) 

    Trying to have baby #1 since April 2013

    DH SA March,May 2014 - Low motility and shape issues. On vitamins per RE to help

    Me testing April 3, 2014 - FSH and LH good, HSG showed blocked right tube

    April 29, 2014 - First RE appt., right tube needs to be removed and possibly left also if

    it's bad too. RE suggests going straight to IVF

    June 4, 2014 - LAP/HSC and unexpected endo. removed but tubes got to stay!

    June 13, 2014 - Post-Op appointment. We decide where to go next since main issue

    is MFI influenced. Trying naturally until decision... Repeat SA  in September. Aiming for IUI #1 November 2014.

    image

  • Hi, I am also starting to go through testing with an RE. Your list sounds good so far! One thing I didn't get a chance to ask (aka forgot) was how to/when I could meet with one of the financial advisor people that they have. I'd like to know what things will cost since we are OOP. Good luck!
    ***********siggy warning **********



    Me: 26 DH: 27
    TTC #1 Since Aug. 2013
    Cycle 1: O CD 25=bfn
    Cycle 2: O CD 48=bfn
    Cycle 3: Anovulatory/Provera =120 days!
    Cycle 4: Anovulatory/Prometrium=127 days! RE consult 6/16
    Me: Anov/poss. pcos?  HSG=normal/SA= Normal 
    July/Aug. 2014= Femara+trigger+TI=BFP!!
    Beta #1@ 16dpo=626!! Beta #2=1510
    Ultrasound @ 5w6d=heartbeat at 110!
    Ultrasound @ 6w6d =heartbeat at 131!


    Pregnancy Ticker

    image
  • @viola27, thank you for that advice!  Sometimes if things sound like solid plans, I can get caught up and not take the time to think through if the plan is a good fit.  I will definitely remind myself to do that!  I never thought an RE would ask the patient what SHE thought she'd want to do.  Thank you for the head's up!!    

    @catlover790, yes!  The finances will be huge.  I live in Illinois where there is mandated fertility coverage, but not everything is always covered.  So sitting down with the finance people will be key.  I've just added that to the list!  Good luck to you too as you start out with the RE!

    Me: 28  MH:35

    Married September 2012. TTC since September 2013

    June 2014 - Dx w/ significant PCOS and referred to RE.

    July/August 2014 - Testing complete: Testosterone & AMH very high, FSH slightly high, Vitamin D low, tubes and lining all lovely. DH SA: A+

    Cycle 1 (Nov 2014): 2.5 mg Letrozole/Ovidrel/TI = BFN

    Cycle 2 (Dec 2014): 5 mg Letrozole/Ovidrel/TI - BFN

    Cycle 3 (Jan 2015): 5mg Letrozole/Ovidrel/TI - BFN

    WTF consult scheduled for 1/29

  • @LindseyM2012‌ That is great to have at least some coverage, yay! Good luck at your appointment! Thanks for the support too!
    ***********siggy warning **********



    Me: 26 DH: 27
    TTC #1 Since Aug. 2013
    Cycle 1: O CD 25=bfn
    Cycle 2: O CD 48=bfn
    Cycle 3: Anovulatory/Provera =120 days!
    Cycle 4: Anovulatory/Prometrium=127 days! RE consult 6/16
    Me: Anov/poss. pcos?  HSG=normal/SA= Normal 
    July/Aug. 2014= Femara+trigger+TI=BFP!!
    Beta #1@ 16dpo=626!! Beta #2=1510
    Ultrasound @ 5w6d=heartbeat at 110!
    Ultrasound @ 6w6d =heartbeat at 131!


    Pregnancy Ticker

    image
  • Most likely your RE will have you and your partner undergo some more testing, perhaps for 1 cycle, before determining the final diagnosis and treatment plan. So I would ask about the timing and - since you like to understand things, as you said - purpose of each test (SA, HSG, bloodwork at certain times).


    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • Just wanted to which you good luck! And remember -- you can always ask questions/change courses along the way, so don't feel like you need to get them all taken care of on your initial visits :)
    Tried for two years, finally a BFP!
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