Intro post, with treatment guesses welcome

mbrus · December 2014

History: dx with PCOS at 19, irregular cycles for as long as I remember. On and off BCP before I got married, but consistently on BCP since married at 25 (now mid 30s). Went off BCP to TTC in spring 2013 and waiting to see if my cycle might regulate. It didn't. In December 2013 I saw OBGYN for irregular bleeding and to discuss TTC. At that time I went back on BCP to await u/s and eventual HSC with polyp removal in spring 2014. Went off BCP again after HSC recovery. DH did SA in late spring 2014 before I went on any meds. Did three cycles of Clomid 50mg cd3-7 with OBGYN over summer 2014. Did minimal blood work monitoring, no u/s monitoring, and used OPKS. OPKs and blood work confirmed ovulation 2/3 months I was on Clomid. After O was not detected in 3rd month on Clomid, I was referred to an RE. I just did a HSG and confirmed clear tubes. Have an appointment the week after next to discuss treatment options. If you have PCOS, clear tubes, and good SA, where did your RE begin with treatments?

meredithcarole · December 2014

I'm no expert, but wouldn't regulating your cycles be a good place to start? Clomid didn't seem to work (and unmonitored isn't good in the first place), but maybe Metformin? They will probably recommend medicated cycles with iui ultimately, as it seems to be the goto initial treatment. Good luck.

cbnola71 · December 2014

I am not a RE, so I cannot say what your RE will do, but AFM, I was in a similar situation a few months ago as you. My RE started conservatively with a monitored cycle with CD3 blood work, U/S, and then letrozole (Femera). I had an US on CD12, decided to do a trigger shot to induce ovulation and then do TI. I think most REs start with something along those lines, unless you have a more significant diagnosis that needs assistive reproductive technology like IUI or IVF.

Good luck with your RE and welcome!

tlc35 · December 2014

Welcome, I am glad you are working with a RE now.

sunshine412 · December 2014

Welcome! Sorry you have to be here, but it sounds like you're in the right place. I'm technically annovulatory with polycystic ovaries (not officially PCOS). My RE had me start on clomid and recommended IUI. DH wanted to start as "naturally" as possible, so we did timed intercourse for two cycles. The RE gave us our options, but really left it up to us to decide how aggressive we wanted to be with treatment. Good luck!

mshandlebar · December 2014

Welcome. I don't know much about treatment options for your situation, but I wish you the best of luck with the RE next week

mbrus · December 2014

BlueFairy5 said:

So glad you're working with an RE now. I also have PCOS, and you can almost copy/paste @cbnola71's, except my RE went with Clomid instead of Femara. It does seem to be a pretty standard spot to start with PCOS (and they'd most likely have you start with TI rather than IUI, unless there were any potential issues that showed up in the SA).

Thanks to all of you, especially those with similar experience. No issues on SA. Since I didn't respond reliably well to Clomid, I'm hoping to try femara and TI. If necessary, can they add trigger during a femara cycle, if it's deemed the treatment isn't sufficient?

mbrus · December 2014

BlueFairy5 said:

I don't have any Femara experience firsthand, but it took my first cycle with my RE to discover that I respond to Clomid in that I produce follicles, but I don't ovulate without the trigger. So if they don't add a trigger the first cycle, they'll know by the second if you need one. (That said, I wish my RE's practice did triggers as SOP, because then we wouldn't have "lost" that month.)

So do I have to "lose" a cycle if we don't plan for a trigger and I needed it, or can they catch the non-response and add a trigger within that cycle if we're watching for it?

SND1231 · December 2014

Welcome. I do not have PCOS but did just finish a cycle with Femera. It was my first cycle. I was completely annovulatory on my own. I did normal baseline b/w and ultrasound. Then a mid cycle u/s where my follicle wasn't ready yet so I went back a few days later they were happy with where it was and told me to trigger that night as my body didn't seem ready to O on its own. They kind of based my trigger or not to trigger as to how my body responded. Since I needed the trigger the first cycle I am assuming I will plan on it for the remainder of my cycles as well. I am not sure what your RE will decided is best for your situation as everyone is different. That is just my experience with Femera, trigger, and TI. Good luck!

mbrus · December 2014

Thanks, snd1213. That's good background.

redandblue · December 2014

Welcome and sorry you finnd yourself here. Like PP said I'm not sure exactly what your RE will decide. I don't have PCOS but have experience with Femera. I have done 3 cycles medicated. They have monitored closely each cycle, the first cycle they said I was showing some signs of LH surge, but didn't want to risk me not o'ing on my own, so they gave me the trigger and had IUI the next day. My second cycle they just automatically gave me the trigger (not sure why) and then IUI the following day. This month they waited to get my BW which showed I was having my LH surge, so said I did not need the trigger. We are doing TI this cycle, so I will go tomorrow am to confirm whether I did O. Good luck with your appointment.

BunnyBerry · December 2014

Welcome, though sorry you have to be here! Glad you're working with an RE. And congrats on clear tubes!

With a good SA, it will likely be an option to go with TI at first.

If you want a trigger, you could just explain that OPKs have not been reliable for you in the past. They will probably be happy to add a trigger shot.

MustangChic · December 2014

Welcome, but sorry you find yourself here. Glad you are with an RE now!

I too have a dx of PCOS. Ditto what @cbnola71‌ said, but I am taking letrozole instead of clomid. I do not have a trigger shot planned for this cycle and am now starting to worry about loosing a month like @BlueFairy5‌ pointed out. Great advice about the trigger shot @BunnyBerry‌.

This board is truly amazing and the ladies are very knowledgable. GL and I hope your stay is short!

Want a personalized experience?

Intro post, with treatment guesses welcome

Re: Intro post, with treatment guesses welcome

Choose Another Board

Search Boards