Talk to me about PCOS and fertility...update

[Ann.without.an.e]

 

UPDATE to last post 🙂 

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

DD and SIL really want a baby. They have been actively trying for 9 months. DD has PCOS. Without treatment, she tends to have extremely high testosterone levels and very low progesterone levels (like almost non existent). She is on spironolactone to reduce the testosterone and prescription progesterone, the pharmaceutical kind and not a cream, her levels are too low for a natural supplement. She has never been on BC. Her doctor has done extensive research and firmly believes that those with PCOS have a better chance conceiving if BC is not in the mix. 

She's discouraged, especially since she already had this sinking feeling she wouldn't be able to conceive. She and SIL talked about this thoroughly when they first started dating so this is no surprise to him. I talked her into seeing her doctor and she started her on metformin. Dr is convinced that dd isn't ovulating and metformin can sometimes kick that into gear. 

DD says she will not do IVF. She would rather put the money and energy into adoption. But she is willing to try a few less invasive things first. I would love to know your experiences if you have PCOS and were able to conceive. What measures did you have to go to? What are the less invasive options out there? I'd love to have encouraging stories to share with dd about things that worked for others. 

ETA: I'd also love to hear anything natural you did that helped. DD is bad about not eating all day and her doctor talked to her about how she needs to eat more consistently. Anything else?

Edited July 18, 2022 by Ann.without.an.e

[Corraleno]

I had a friend with PCOS who had good results with a combination of Clomid and metformin; the combination seems to have better results than metformin alone. There's some info about it here: https://advancedfertility.com/fertility-medications/clomid-metformin-treatment/

That website says it can take 2-3 months for metformin to really have an effect, and suggests starting metformin first and then adding Clomid. I think the next step if Clomid + metformin doesn't work would be injectable FSH. 

[EKS]

My friend had PCOS and was able to conceive with some medical intervention.  They did not do IVF.  She was on birth control pills for years prior to conceiving.  I don't know any more details and can't ask her because she is no longer with us.  Her daughter is graduating from college today.

[Matryoshka]

I had PCOS.  I do think being on BC to 'control' it screwed me up rather than helping.  After I went off to TTC, everything was so far out of whack, and instead of irregular periods, there was... nothing.  For a whole year.  Metformin was brand-spanking new back then as a possible treatment; I wasn't offered it, but that could also partly be because I was a 'skinny PCOSer' - though I still had high testosterone, low progesterone, and that hormone that tells you you're ovulating (LH?) - so high I could turn an ovulation test positive every day of the week - but yeah, I wasn't ovulating.  Tried all the standard things, Clomid was a dud, IUI didn't work because I was so sensitive to the injected hormones that I'd have 40 eggs develop all at once - or none.  Either way, cycle cancelled.  I did finally try IVF; fortunately my state is one of 2? that covered IVF treatments.  Had twins.  All that took 3 years.

After that, wanted to try more 'natural' methods to bring things under control.  Tried the ol' low carb diet (not keto, but no sugar/white flour/rice/high glycemic index stuff), along with some herbal supplements (vitex, L-Carntine, some other stuff I forget).  Read Taking Charge of Your Fertility, learned to track my temps.  First time temps showed ovulation, I told dh, hey, this seems to be working, let's wait to actually try hard till the twins are a little older.  Temps never went down again.  I went, okay, what's this crazy?  Oop, that was Kid #3.  So... that worked.  I'll never know if it was all my 'natural' methods or if being pregnant previously managed to reset me a bit somehow, or a combination of both.   

Edited May 15, 2022 by Matryoshka

[alysee]

A more natural approach is also Napro using the Creighton Method. 

https://fertilitycare.org/what-is-naprotechnology

[Ann.without.an.e]

9 minutes ago, Matryoshka said:

I had PCOS.  I do think being on BC to 'control' it screwed me up rather than helping.  After I went off to TTC, everything was so far out of whack, and instead of irregular periods, there was... nothing.  For a whole year.  Metformin was brand-spanking new back then as a possible treatment; I wasn't offered it, but that could also partly be because I was a 'skinny PCOSer' - though I still had high testosterone, low progesterone, and that hormone that tells you you're ovulating (LH?) - so high I could turn an ovulation test positive every day of the week - but yeah, I wasn't ovulating.  Tried all the standard things, Clomid was a dud, IUI didn't work because I was so sensitive to the injected hormones that I'd have 40 eggs develop all at once - or none.  Either way, cycle cancelled.  I did finally try IVF; fortunately my state is one of 2? that covered IVF treatments.  Had twins.  All that took 3 years.

After that, wanted to try more 'natural' methods to bring things under control.  Tried the ol' low carb diet (not keto, but no sugar/white flour/rice/high glycemic index stuff), along with some herbal supplements (vitex, L-Carntine, some other stuff I forget).  Read Taking Charge of Your Fertility, learned to track my temps.  First time temps showed ovulation, I told dh, hey, this seems to be working, let's wait to actually try hard till the twins are a little older.  Temps never went down again.  I went, okay, what's this crazy?  Oop, that was Kid #3.  So... that worked.  I'll never know if it was all my 'natural' methods or if being pregnant previously managed to reset me a bit somehow, or a combination of both.   

 

BC screws up a lot people with PCOS. I'm glad IVF worked for you. She isn't big either so I hope the metformin doesn't make her too sick. She is already completely sugar free so that cuts down carbs for her. I will look into the book you mentioned. 

[Selkie]

I don't have PCOS, but heard a very interesting interview about it with Dr. Nitu Bajekal recently. She's an OB-GYN in London who is an expert on all things PCOS, and has lots of advice related to lifestyle approaches that are helpful.

She wrote a book about PCOS with her daughter, who is a nutritionist and has PCOS herself.

https://smile.amazon.com/Living-PCOS-Free-hormonal-polycystic-ebook/dp/B09QPM56KG/ref=sr_1_1?crid=2VV1KDULG8M63&keywords=nitu+bajekal&qid=1652625653&sprefix=nite%2Caps%2C226&sr=8-1

[Mrs Tiggywinkle]

I conceived once on clomid and metformin; once on clomid, metformin and Letrozole; and once completely unexpectedly and unassisted lol.  I’ve had pcos since I was 14 or 15.  I take spironolactone and a birth control pill daily as well as Ozempic for diabetes, as I’m diabetic now.  
for the first two pregnancies I also took a progesterone supplement as soon  as I knew I was pregnant until about 15 weeks. With the unexpected child I didn’t know I was pregnant till late in the first trimester, so no progesterone there.  

 

[Sneezyone]

I didn’t have any success or symptom improvement with clomid or metformin. We needed IVF to conceive our bio kiddo and I had progesterone shots for the first three months.

[busymama7]

I was just recommended this book (not for me but for someone I know who is TTC with PCOS).

My friend had a friend who tried for 7 years, had one successful IVF and then used this method and was pregnant in 3 months with no other intervention.  She did everything in this book including acupuncture.

 

Making Babies: A Proven 3-Month Program for Maximum Fertility https://www.amazon.com/dp/0316024503/ref=cm_sw_r_sms_c_api_ILG1Ab0JY6CVE

[Sneezyone]

14 minutes ago, busymama7 said:

I was just recommended this book (not for me but for someone I know who is TTC with PCOS).

My friend had a friend who tried for 7 years, had one successful IVF and then used this method and was pregnant in 3 months with no other intervention.  She did everything in this book including acupuncture.

 

Making Babies: A Proven 3-Month Program for Maximum Fertility https://www.amazon.com/dp/0316024503/ref=cm_sw_r_sms_c_api_ILG1Ab0JY6CVE

I used acupuncture during our IVF cycle. I found it really relaxing, not painful at all, and I could DEFINITELY feel a difference after a session. My acupuncturist specialized in fertility enhancement and knew I was pregnant before I did. She worked with me throughout the pregnancy.

Edited May 15, 2022 by Sneezyone

[Ann.without.an.e]

She tested positive last week!!!!!!! She isn't telling others yet but no one here knows me IRL so I feel like this is a safe space to say something. Only a few months on metformin and bam. She had that long bleeding time after starting metformin but it seems that was her body kicking in to ovulate or something? After the 40+ days of bleeding, it appears she ovulated the next cycle and that is all it took!!  They are over the moon. Now we just have to pray that things stay positive 🙂 

If any of y'all have any experiences to share, I'm open.

Her doctor says she needs to stop Metformin but I read that staying on it decreases miscarriage rates??

Also, she can't stay on Spiro just in case it is a boy but what about a spike in testosterone? Doesn't that cause miscarriage too? 

 

[Elizabeth86]

1 minute ago, Ann.without.an.e said:

She tested positive last week!!!!!!! She isn't telling others yet but no one here knows me IRL so I feel like this is a safe space to say something. Only a few months on metformin and bam. She had that long bleeding time after starting metformin but it seems that was her body kicking in to ovulate or something? After the 40+ days of bleeding, it appears she ovulated the next cycle and that is all it took!!  They are over the moon. Now we just have to pray that things stay positive 🙂 

If any of y'all have any experiences to share, I'm open.

Her doctor says she needs to stop Metformin but I read that staying on it decreases miscarriage rates??

Also, she can't stay on Spiro just in case it is a boy but what about a spike in testosterone? Doesn't that cause miscarriage too? 

 

What a blessing! So happy for them!

[Kassia]

Yes, such wonderful news!  Wishing her all the best!  ❤️

 

[mommyoffive]

AWWWW!!!!  Congrats.  Wishing her the best.   This is the only time I have heard in the last few weeks when testing positive is a good thing!!  🙂  Yay.

[Sneezyone]

Congrats! Those hard-fought wins feel so good!

[Spryte]

Congratulations!

[ktgrok]

Can she ask to consult with a maternal fetal specialist? They may have more answers than regular OB. 

[Ann.without.an.e]

53 minutes ago, ktgrok said:

Can she ask to consult with a maternal fetal specialist? They may have more answers than regular OB. 

where would one find that?

[Corraleno]

4 hours ago, Ann.without.an.e said:

Her doctor says she needs to stop Metformin but I read that staying on it decreases miscarriage rates??

https://www.pcosliving.com/pcos-living-blog/4-natural-alternatives-to-metformin

This is an article about natural alternatives to metformin, like berberine, NAC, and inositol, which some studies suggest work as well as metformin in PCOS patients, but without the side effects. Maybe she can ask her doc if it would be ok to take one of these instead? (And NAC is also supposed to protect the lungs against damage from respiratory infections, so that might provide an extra layer of protection against covid.) Amazon no longer sells NAC, but you can get it from iHerb and many health food type stores that sell supplements.

 

[Ann.without.an.e]

3 minutes ago, Corraleno said:

https://www.pcosliving.com/pcos-living-blog/4-natural-alternatives-to-metformin

This is an article about natural alternatives to metformin, like berberine, NAC, and inositol, which some studies suggest work as well as metformin in PCOS patients, but without the side effects. Maybe she can ask her doc if it would be ok to take one of these instead? (And NAC is also supposed to protect the lungs against damage from respiratory infections, so that might provide an extra layer of protection against covid.) Amazon no longer sells NAC, but you can get it from iHerb and many health food type stores that sell supplements.

 

I sent her the article. Thanks 

Edited July 18, 2022 by Ann.without.an.e

[Jann in TX]

My dd stayed on Metformin for most if not all of the first trimester then tapered off-- Dr said that baby was able to 'naturally' help.

My dd did consult an RE (reproductive endocrinologist) due to the meds she was taking when she got pregnant-- I saw an RE for the first 2 trimesters of my last pregnancy due to high risk of miscarriage.

Praying for a healthy baby!

[melmichigan]

I was prescribed metformin, I had my first few pregnancies using injections, after a disastrous experience with clomid. Over time the metformin reversed by PCOS and my last few pregnancies were conceived naturally.  I tried inositol at one point and went back on metformin because it got so out of control.

Congratulations on your update!  I took metformin until I hit 12 weeks with each pregnancy. I also took progesterone for the same period of time.

Edited July 19, 2022 by melmichigan

[ktgrok]

1 hour ago, Ann.without.an.e said:

where would one find that?

she could call the Ob's office and ask which maternal fetal specialists they work with. Or, consult a reproductive endocrinologist.