PCOS and using a fertility monitor?

[aksmith]

Hi there,

My name is Ali and I have been TTCing for 1 and 1/2 years (I had a m/c in June). I have PCOS. I was wondering if anyone had tried using a fertility monitor? I am thinking of buying Clear Blue Easy fertility monitor but saw that there is a disclaimer saying it might not work for people with PCOS. Just wondering if anyone had any experience with that?

Thanks,
Ali

[jarkleinhans]

hey ali. i saw your thread and thought i'd drop you a note. I haven't tried using clear blue easy so i'm not to sure how accurate those things are. good luck in tcc'ing!!!!

[eaglet]

Unless your pcos is being treated with an insulin sensitizer like metformin, it is likely that your hormones are too out of whack for either the clearplan monitor or the clearplan OPKs to be useful.

Most people with pcos have an LH level that is too high most of the time. LH is the hormone that the OPK and the monitor both test for (I think the monitor also tests for something additional, maybe estrogen). They test for LH because in a normal cycle, there is a surge of LH just prior to ovulation (actually, the LH finalizes the maturation of the egg and causes ovulation; in stimulation cycles, the doctors use hCG, which is chemically very similar, to mimic LH). But when a person with pcos uses OPK sticks (or the sticks for the monitor), and the sticks detect LH, you won't know whether it is an actual LH surge predicting ovulation or whether it is just the over-abundance of LH that we pcos'ers tend to have *a lot* of the time.

As an example, just before I was diagnosed with pcos, I had two positive OPKs a week apart - very confusing. My BBT chart showed no ovulation. Indeed, I wasn't ovulating.

Which brings up an important point: if you're not ovulating, obviously no OPK or clearplan monitor can help you get pregnant.

Both the OPK test sticks and the test sticks for the clearplan monitor are rather expensive, so plan for taking them for a while if you have the long, irregular cycles typical of pcos. And, whether or not you do OPKs or the monitor, my advice would be to track BBT in addition to that. It can't predict ovulation, but it provides a pretty darn good record after the fact. If your temps are all over the place, a big mess, then you're probably not ovulating. If you don't know about charting, the place to learn is Toni Wechsler's "Taking Charge of Your Fertility" and also http://www.fertilityfriend.com/ (free on-line charting).

I would also like to say that I have had success with the OPKs since I have been taking metformin (I've actually been taking metformin for over a year and a half, and now that we're about to ttc again I'm charting cycles). I have a clearplan monitor from a couple of years ago; I didn't have success with it in the past because I wasn't ovulating. I might dust it off and crank it up next month if I can get around to buying some sticks for it. I've already started building a nice record of charts though, so I have a better idea of when to expect ovulation (I've been having very regular cycles!), so I don't know what the monitor would really do for me. But the OPKs have been working on metformin - it's so funny to see them work (too bad DH has been out of town when I got the +OPKs).

Bottom line, in my opinion, the clearplan monitor is not worth the expense if your pcos is not being treated (at the root cause, with an insulin sensitizer like metformin). If you just want to see where things stand as far as what the LH sticks would show, it would be cheaper just to get some OPKs. Costco sells a box of 10 clearplan OPK sticks for $20. The main benefit of the monitor over the OPKs is that it attempts to predict ovulation a few more days in advance than the OPK does (ovulation occurs something like 12-48 hrs after a positive OPK). But, the monitor is only going to frustrate you (and cost you money) *if* your hormones are out of whack and/or you're not ovulating.

Ali, I'm very sorry about your loss. I hope you've been reading the posts about metformin reducing the m/c rate with pcos from 45% down to 9%. Something to consider with your history. Let us know if you want to see links about that.

Good luck and please keep us updated!
-eaglet

[aksmith]

Thanks so much for your responses. I really appreciate the info. I m/c in June at 14 weeks. I got my af exactly one month after my m/c and then regularly for 3 months. I then skipped a period and my doctor sent me to a ob/gyn (who treated me during my m/c). He listened to my symptoms - I have also had ovarian cysts and weight gain - and said I sound like I have PCOS. I asked what to do - he said we will put you on Clomid for a few months - he seemed positive as I got pg by myself in the spring. Nothing seems to be happening so I don't know. Since the fall, I have had regular periods so I don't know if I am ovulating or not. I appreciate all your info since it gives me more knowledge to go back to the ob/gyn with. I also got a great book about PCOS which is helping me lose weight - something I gained more of after m/cing. I don't go back to the ob/gyn until May but I am going to be armed with tons of questions when I do. I was sort of shocked at my last appointment but will definitely be educated and prepared at the next one. We started ttcing 1 and 1/2 years ago - and are at the same place we were then . Thanks for your help and support!
Ali

[eaglet]

Ali - if you're trying to figure out whether you've been ovulating, then I highly recommend charting BBT. And if you are ovulating within a reasonable amount of time (like by cd 21 or something), then you do not need clomid. In such situations, sometimes clomid can hurt more than it helps (it has a negative effect on the cervical fluid and uterine lining, so much so that it becomes a contraceptive after 3-6 months).

If you do take clomid, I also highly recommend that you see an RE for that. Too often ob/gyn's, who just dabble in fertility treatment, fail to do necessary things, like a mid-cycle ultrasound to check follicle development, and a semen analysis and HSG (which should *always always always* be done before clomid and are part of a standard fertility workup) (Ali, I'm emphasizing this for the lurkers!).

If you do in fact have pcos, which should be confirmed by ultrasound (you've already had one, right?) and bloodwork (testosterone levels and/or LH to FSH ratio), metformin is the latest treatment, and may be taken alone for a few months prior to adding clomid.

-eaglet

[aksmith]

Hi there,

Thanks again for your info . I have had an ultrasound but no blood work done. I am definitely going to be looking into this. I have a dr. appointment next week with my family GP and I'll talk to her about this - she is really good and was involved in my first pg until I m/c. Does an RE see you for PCOS or your family DR? It is kind of scary that my ob/gyn so quickly prescribed clomid - I haven't had any tests and don't see him again until May. I am getting concerned. I am going to track my cycle this month - I just got my af today - it was exactly 30 days since last month - but you can have your period without ovulating. I will try the tracking before I spend lots of money on anything else. Thanks for the advice !

Ali

[eaglet]

Ali - for pcos when not ttc, I see an endocrinologist (I am lucky enough to have one who treats pcos - many do not - if you ever need one, it is best to start looking at a practice based at a large university medical center, and find the youngest dr in the group - they are often the most up to date when it comes to things on the cutting edge). My endocrinologist has me on metformin. When ttc, I see an RE, because I have other issues to be treated (immune and clotting stuff).

wow, a 30-day cycle sounds pretty darn good - I hope you're ovulating!! Good luck and please keep us updated!!

if you do have pcos, don't forget about the m/c angle with the metformin (I think I posted my long list of links in response to someone's post sometime in the last few weeks).

and remember, don't take clomid without requesting a semen analysis and an HSG (they shouldn't be a big deal; the dr is probably figuring that you got pg once so your tubes probably aren't blocked and the sperm are probably good to go, but better safe than sorry).

[darkprincess]

I'm feel sooo in the dark with my doctor, i've posted before..my dx is pco as of 2months ago, the dr. did blood work alone, which is what he based his dx on. I have a almost 2 yr old daughter, whom we tried for almost a year but with no meds. I just thought it took awhile....i didnt know about pcos....Now we've been trying 9months or so for # 2 and 2 months ago is when i when went to the dr and asked for bloodwork b/c i had long cycles and didnt think i was ovulating. So now here i am, just finished month2 of clomid, 100mg....and my dr hasnt done any mid-cycle ultra sound, all he did is that endo-biopsy, which almost killed me..lol and he couldnt even get the biopsy so that didnt tell us anything...Im feeling very confused and lost and now depressed...im only 24 and now im taking this drug and i dont even know if its working....the first month i dont think i even o'd and this month i pray i did....the fertility monitor said so plus i got the O pain, but i know i cant take the monitor 100% seriously while on 100mg of clomid...which i didnt know til after i bought the $50 sticks...lol

Why....why do some doctors not give you the whole scoop...i've research it all online my self, he didnt even explain pco and pcos to me.
If i dont get pregnant this month and use clomid one more cycle (3rd time) should i stop it?? i dont want it to do harm...i have no clue what to do....any advice?

But i want to thank everyone who posts here, b/c you have answered alot of my questions and help me not feel alone,
Thank you!!

[aksmith]

Thanks once again for the info - I feel much more confident going to my dr (s). I think my previous pg is the reason more tests weren't done but I WILL be looking into and the m/c factor as well. Thanks so much .

darkprincess - your doctor situation sounds similar to mine (except I am ttcing #1). Its amazing how drs just say something and leave the room and we sit their uninformed about our own bodies. I have checked out the site www.fertilityfriend.com and it seems REALLY good. I plan on charting my cycle this month. It is definitely worth a look!

Ali

[eaglet]

Ali - glad you looked at that site. I am using that site right now for my charting (back in the old days, 6 years ago, I used to make my own charts using a spreadsheet program, at work LOL, but this is so much easier).

darkprincess - here is my advice about clomid. Yes, you can do one more cycle. Then you must take a break from it for a cycle or two to give your lining and cervical mucus a chance to come back (a chance to clear out the estrogen receptors). But, the common wisdom is that after 3 cycles of any treatment, it's time to move on to something different or to somehow change what you're doing in the cycles. My advice, as you probably know if you've read my other posts, would be to try metformin if you haven't already. I succeeded with metformin alone after 6 failed clomid cycles and 4 failed IVFs. And my other advice is to chart BBT. It is a much more reliable record of ovulation than either the monitor or the opks.

Ali - you have interested me in my old monitor again, perhaps I will dust it off and try to remember how to work it. I did look up getting the sticks from Costco - I can get a box of 30 for $38 or something, at least on-line - I need to check at the store. In case I'm not tracking things enough with charting and OPK (the monitor is probably overkill for me, LOL, but fun).

Keep us updated, ladies!! Maybe someone should start a cycle thread - I don't really know who else is cycling these days other than that one huge thread....