PCOS and IVF?

[tptbabe]

So, years ago, my cycles were completely out of whack. (We're talking anywhere from 3 weeks to 8 months between AF.) I had all the symptoms of PCOS, but because I lived in a tiny community growing up, it was never investigated. (And once by the time I graduated HS and moved out of there, I was on BCP, so it masked the issues obviously.) My cycles have somewhat regulated themselves over the years, and I ovulate every cycle that I've charted (in the last 9 years or so?).

That being said, my LP had become way too short again (8 days - this was improved with acupuncture, but I haven't been in awhile) and I'm getting 4-5 days in a row of +OPKs again. (Yes, I still OPK.), I'm breaking out like a mo-fo, and my A1C was slightly elevated at last check (6.2). My skin is also rebelling against me, but that is likely another issue...

After all that, I guess my question is, should I be concerned about any of this? I mean, we're doing IVF anyways, right? When I brought up my LP issue at our last RE appointment, she didn't really mention anything? I plan on asking to have my A1C checked again (and my TSH, because they're taking blood anyways, right?) from my GP, but if it's gotten worse, should I be asking for Metformin before cycling? I've been eating a PCOS diet regardless the last few months (as per my nutritionist), but this is actually getting worse?

FTR, I've never actually been Dx with PCOS, and I've never had PCO on ultrasound. I'm just curious/paranoid if this is what's going on?

[bluefairy5]

Gotta love longterm BCP for making you think all's well, right? LOLsob.

I feel like the only one who's going to be able to truly answer these questions (especially about Metformin) is your RE. In your siggy I see you have some autoimmune issues - could some of this be related to that do you think? I know a lot of autoimmune conditions produce quite a lot of inflammation, which is definitely related to acne (thanks, excess testosterone!) I know one of the things acupuncture is supposed to alleviate is inflammation: have you seen a big correlation in timing there?

My gut tells me that A1C should be under control before cycling in the same way you'd want TSH under control, but that's not based on any actual knowledge.

[tptbabe]

bluefairy5 - Yes, definitely have some autoimmune issues! One of which is Hashimotos, and I know that thyroid issues and PCOS can be intertwined? I've definitely noticed a big difference when I wasn't doing acupuncture. My fibro started flaring after our last cycle as well, and it was when I stopped acupuncture.

RE said that my A1C was "fine" (and didn't actually test it herself, it was done by my GP at my annual because my brother is T2D - and also has autoimmune issues) so I guess that's why I'm asking here? She didn't seem to think it was a big deal. I question absolutely everything. RE knows that, so I don't know if she was just brushing me off, or if I should actually look into it more?

[bluefairy5]

I hate that potential brush-off feeling from medical professionals. Perhaps she was thinking "all other things being equal, it won't make or break anything," but I can see what you're uncertain. Maybe the upcoming b/w with your GP will either show it's the same or lower (in which case, great) or if it's continuing to trend upward, perhaps it's something the RE will be forced to look at a little more closely.

FWIW, I had a GP in November try to talk me out of the idea that I had PCOS at all, simply because my BMI was within "normal" range. So I definitely get you on the "would you please take me seriously??" feeling.

For PCOS, since you've never had a PCO u/s, when they test your CD3 FSH/LH, are they in the right ration or has the LH ever been a bit higher? That's one of the big non-u/s indicators, from what I understand. (Charts/WebMD type articles will tell you the PCOS ration is 1:2, but mine is more like 1:1.5 and they still considered that a sign.)

[tptbabe]

bluefairy5 - I don't know what the ratio is, but I know that they've checked both? I'm not slated to have another draw until just before we start stims though. Maybe I'll ask for it before starting BCP if my b/w shows anything? (I'm already on CD6 of this cycle, starting BCP next CD3.)

[NariaDreaming]

I'd ask about the metformin. No harm in it.