I finally decided to pull the trigger - I have come to terms with the fact that we will most likely need help to get and stay pregnant.
Back in January 2014 I was in this same spot. I saw an RE, but didn't really like him and decided to check out somebody else. In the meantime I went on Metformin, and got lucky - we got pregnant naturally on that first ovulatory cycle after eight months of anovulation. In April I had a mmc at 11 weeks.
Now it's been almost a year since my loss, and I seem to be ovulating, but my cycles are progressively getting worse. I went from ovulating around CD20, to CD25, to CD30. My LP is also a bit short at 9-10 days, and this cycle I started spotting a little starting around 4 or 5 dpo. I found a new RE that actually works in an office that has a PCOS center, so I'm hopefully that they will be able to give me some specialized care.
So - what questions should I make sure I ask this new RE? Should I ask for any additional testing? Maybe recheck my hormone levels since its been so long? I have heard that femera has been shown more effective in women with PCOS than clomid - should I ask about trying that first?
Post by anonymouseliza on Mar 30, 2015 19:19:50 GMT -5
Since it's been so long they will almost certainly want to re-test your levels and do a new semen analysis for DH. It sounds really positive that you have expertise so closely tied with the new RE. Good luck tomorrow!
Post by icaughtfire on Mar 30, 2015 19:21:48 GMT -5
I don't have any advice regarding the RE, but I know there's plenty of knowledgable ladies here that can help you with that! I just wanted to wish you luck with the RE!! I'll be thinking of ya!
Last Edit: Mar 30, 2015 19:31:54 GMT -5 by icaughtfire
Number One: Born 06.16.2009 BFP: 01.17.2014 / MC 02.05.2014 BFP: 03.08.2014 / MMC: 05.07.2014 Dx: Partial Molar/GTD. Benched until 01.2015 Number Two: Born 07.22.2016
Post by lovegrilledcheese on Mar 30, 2015 19:25:38 GMT -5
I am sorry that you are having to go down this route. Big hugs to you. My RE requires retesting if has been more than a year. There is a recent thread on TTTC that says some RE's requires retesting after a year. So I would think they would probably do a ultrasound, saline sonogram, bloodwork (cd 3), and an SA. I think there is a list of questions to ask an RE on the newbie blog of TTTC and it has some good info in it. I hope you have a better experience with this RE.
******Loss Mentioned***** Me-Stage 3 Endo DH-MFI Nov and Dec 2014-Letrozole+trigger+IUI=BFN Jan 2015: IVF#1:ET cancelled due to severe OHSS FET #1: April 2015=BFP 4/10 & M/C 4/27 & D&C 5/15 Hysteroscopy and polypectomy 7/31 FET #2: Aug-Cxl FET #2.1 9/18-BFFN FET #3: 10/23-
I am sorry that you are having to go down this route. Big hugs to you. My RE requires retesting if has been more than a year. There is a recent thread on TTTC that says some RE's requires retesting after a year. So I would think they would probably do a ultrasound, saline sonogram, bloodwork (cd 3), and an SA. I think there is a list of questions to ask an RE on the newbie blog of TTTC and it has some good info in it. I hope you have a better experience with this RE.
Cheese is wise I just finished my round of testing, so I don't have anything to offer except hugs. Good luck!
I am sorry that you are having to go down this route. Big hugs to you. My RE requires retesting if has been more than a year. There is a recent thread on TTTC that says some RE's requires retesting after a year. So I would think they would probably do a ultrasound, saline sonogram, bloodwork (cd 3), and an SA. I think there is a list of questions to ask an RE on the newbie blog of TTTC and it has some good info in it. I hope you have a better experience with this RE.
I will check out that thread, thanks! I need to venture over to tttc more
I am sorry that you are having to go down this route. Big hugs to you. My RE requires retesting if has been more than a year. There is a recent thread on TTTC that says some RE's requires retesting after a year. So I would think they would probably do a ultrasound, saline sonogram, bloodwork (cd 3), and an SA. I think there is a list of questions to ask an RE on the newbie blog of TTTC and it has some good info in it. I hope you have a better experience with this RE.
I will check out that thread, thanks! I need to venture over to tttc more
I have learned a lot being over on that board. They are a wonderful group of ladies over there and I have gotten a lot of support from them. Good luck tomorrow!
******Loss Mentioned***** Me-Stage 3 Endo DH-MFI Nov and Dec 2014-Letrozole+trigger+IUI=BFN Jan 2015: IVF#1:ET cancelled due to severe OHSS FET #1: April 2015=BFP 4/10 & M/C 4/27 & D&C 5/15 Hysteroscopy and polypectomy 7/31 FET #2: Aug-Cxl FET #2.1 9/18-BFFN FET #3: 10/23-
Post by brettanomyces on Mar 30, 2015 20:51:00 GMT -5
Every RE has his own testing protocol, so yours will likely tell you what tests you have to do/re-do. My RE does a complete natural cycle monitoring along with all the other tests, which doesn't seem as common, but might be something to ask about since you have confusing cycles.
I am following this. I just got a PCOS diagnosis. If I am still not having regular cycles by June my doctor wants us to go get checked out by an RE. I am not even sure where to begin. Good luck tomorrow renbee.
Post by twocents6708 on Mar 30, 2015 21:08:55 GMT -5
I think the fact that you have access to an RE at a PCOS center is definitely a positive. I wish we had something like that. I would assume that they will make you redo the bloodwork, SA, and other basic testing. I would ask about the Femara or what the REs plan of action would be for your situation. I would research their success rates and try to determine how quickly they move from basic treatments to IUI/IVF. That would be important to me as we are not sure we are going to go the IVF route and one of the fertility clinics in our area are very much about pushing that. This would just be my advice, it totally depends on what you guys want and need. Best of luck to you!!
Post by madamewaffles on Mar 31, 2015 8:39:36 GMT -5
I second everything lovegrilledcheese said. I too have PCOS and experienced similar cycles where I was ovulating later and later each cycle, with shortening LPs. I hope you like your new RE and can get some answers and a plan in place!
So I liked the RE, she was really friendly, but my appointment just seemed very rushed. I felt like she threw a bunch of information at me and didn't really take the time to listen to my specific situation.
She recommended one of two options: unmonitored clomid (um, wut?!) and monitored letrizole (femera) cycles. I told her I wasn't comfortable with taking clomid unmonitored due to risks of overstimulation and thinned uterine lining. She said that letrizole would be a better bet for me anyways, since studies have shown better success than with clomid in PCOS patients, and there are Not typically issues with uterine lining being thinned on letrizole.
She took a bunch of blood from me today to recheck all of my levels, including blood sugars, thyroid, progesterone (since I happen to be 7dpo), etc. I should get results in about a week. DH will need to do a SA and I will need to have my tubes checked with a procedure called FemVue. Apparently it uses air bubbles and an ultrasound instead of X-ray - supposed to be less painful, so that's good.
The monitored letrizole cycpe sounds like a good option, but am I crazy to move forward with an RE that would even consider unmonitored clomid? I just want to find a doctor that I like and am running out of options...
Post by URMySunshine77 on Mar 31, 2015 16:04:56 GMT -5
Hey renbee, I didn't get the chance to send you good luck yesterday.
I'm glad that certain aspects of your appointment went well. I honestly don't understand her views on Clomid or temping, but if you feel comfortable because she would be monitoring your letrizole, then I would say go for it. You could also give it a couple months and see if you feel rushed or see any warning signs.
Also, she kind of poo-pooed temping, saying she preferred the use of OPKs. I showed her my charts and she seemed completely uninterested.
I will say my RE isn't necessarily on board with temping either. His nurse told me they put more stock in OPKs due to medication messing with temps. I mean, I was still able to see a shift, but it wasn't accurate. For example, my temp jump the first month I was on meds happened the day I got my positive OPK, but I also went in that day for monitoring and the RE said I had not ovulated yet. So I actually didn't even temp this past month (third month medicated).
Also, I don't have any advice regarding her wanting to give you unmonitored Clomid, but others probably will. Just wanted to tell you I hope you get things sorted out soon!
Post by zombiesquad on Mar 31, 2015 16:07:42 GMT -5
I'm confused as to why she would suggest unmonitored clomid cycles but monitored Letrozole cycles given that she's aware that Letrozole tends to have less uterine lining issues than clomid. Wouldn't she want to stress monitored cycles on clomid as well? That just seems backwards.
With something as serious and expensive as medications and procedures, you should absolutely be comfortable with your doctor and the protocol. I know it's time consuming, but it may be worth seeing another doctor just to have additional options.
Married since 2010 DX w/PCOS in Feb 2011 Five cycles w/Letrozole+TI+IUI BFP w/injects+IUI in 2012 DD born May 2013 NTNP since 2015 Early miscarriage March 2015 TTA April/May BFP June! DS born February 2016
Post by wanderingheart on Mar 31, 2015 16:10:30 GMT -5
Her being totally fine with unmonitored Clomid is a huge red flag to me. Also the fact that she prefers OPKs to temping...especially when you have PCOS. OPKS are unreliable when it comes to predicting surges for women with PCOS. I feel like she should definitely know that.
I don't know, this just seems weird to me. I know this is frustrating, but I would be careful.
Also I've never heard of FemVue. I'll have to look into that.
Also, she kind of poo-pooed temping, saying she preferred the use of OPKs. I showed her my charts and she seemed completely uninterested.
I will say my RE isn't necessarily on board with temping either. His nurse told me they put more stock in OPKs due to medication messing with temps. I mean, I was still able to see a shift, but it wasn't accurate. For example, my temp jump the first month I was on meds happened the day I got my positive OPK, but I also went in that day for monitoring and the RE said I had not ovulated yet. So I actually didn't even temp this past month (third month medicated).
Also, I don't have any advice regarding her wanting to give you unmonitored Clomid, but others probably will. Just wanted to tell you I hope you get things sorted out soon!
I understand and agree with this part, but dismissing non-medicated charts would not fly for me.
I will say my RE isn't necessarily on board with temping either. His nurse told me they put more stock in OPKs due to medication messing with temps. I mean, I was still able to see a shift, but it wasn't accurate. For example, my temp jump the first month I was on meds happened the day I got my positive OPK, but I also went in that day for monitoring and the RE said I had not ovulated yet. So I actually didn't even temp this past month (third month medicated).
Also, I don't have any advice regarding her wanting to give you unmonitored Clomid, but others probably will. Just wanted to tell you I hope you get things sorted out soon!
I understand and agree with this part, but dismissing non-medicated charts would not fly for me.
Oh no, that wouldn't fly with me either. Just wondering aloud, basically, if she dismissed them due to already suggesting medication.
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