PCOS'r w/ IUI Questions

girlpooh · 03-09-2005, 09:13 AM

Hello Ladies,
DH & I have been TTC for about 2.5 yrs. I started with Clomid (50mg) and got PG in early Dec just and found out the day I had 1st appt w/an RE. Sadly enough I had a m/c in early Jan. So i have gone back to my RE and am back on the TTC road.

I have recently been diagnosed with a "mild" case of PCOS. I have always had irregular cycles since I have had AF. After the M/C I hadn't had a cycle so they induced my AF to start all the "diagnostic" processes.

Here's where I am so far:
- Went in for day 3 monitoring and everything looks "normal" for my bloodwork except for my prolactin levels - they are really high.
- I had 15 follicles on my right side, and 8 on my left
--What can I expect the next steps to be? What sort of questions should I ask?

My RE wants to do an IUI cycle, w/birth control and clomid. I'm thinking that maybe we should skip the B/C and do something more aggressive. But I don't know..does anyone have any thoughts as to why he would put me on B/C. That just seems backwards to me. They also want me to sign up for injectable classes, so i guess that good?

What can I expect with having PCOS? I did some reading and don't have alot of symptoms that are usually associated with it. I actually only have two and that's irregular cycles and high prolactin levels. I want to know what to look for, when i go to the Dr's. I like to be an informed partner with my treatments rather than just a patient.

Here's where I am so far:

Follicles vs. Cysts
- MY RE refers to them as follicles. He explains that Poly Cystic OS should really be Poly Follicle.... and not cysts. So I'm not sure about terminolgy. At any rate there were the 15 little "dots" on my right side and 8 on my left.

- I did have a small dermoid type of cyst (specifically called it a cyst) on my left ovary that was very small and they don't think it will be a problem.

Bloodwork
- I have had B/W on CD3 and t/v ultrasound
- I don't know what my Prolactin #'s are. I will call and see.

Clomid
- Prior to seeing the RE, I was on Clomid for about 8 cycles thru my OB. The 8th cycle is when i got PG.
- My RE plans to do injectables w/clomid for my IUI

Progesterone
- When i was PG and he looked at my lining, he said it was very healthy and thick. Initially he prescribed the suppository, then he decided that I didn't need it.

Ovulation
- I do not ovulate on my own and noted that out through charting.

SA
- DH had that done and everything looked good.

I had HSG done today and everything is wide open.

Thanks for sharing..I look forward to this journey together.

JenniferK · 03-09-2005, 05:03 PM

I will share what I know from my experience...
I have severe PCOS, no male factor. After TTC with no medical intervention for 3 months ( I was diagnosed years prior, so didn't wait around) went to RE. Started on Clomid for one cycle, my RE said he doesn't believe in using Clomid for more than 3 cycles because it can actually start to have negative effects on fertility (thinning of lining, etc.) so I am surprised you were on it for 8 cycles.
Well, it did drasticly thin my uterine lining and I had no follicle development, so I only used one cycle of Clomid. Then on to injectibles....
I have completed 3 cycles of injectibles (my RE wants to move on to IVF if this cycle doesn't work). I have used BCP between all of my cycles, it is very important for your follies to decrease in numbers and size after a non-successful cycle. In general, BCP's are beneficial to PCOS side-effects, but my understanding is the reason for BCP btwn cycles is 2-fold. 1st to decrease the potential for high-order multiple pregnancies that are risky to moms and babies. Every follicle has the potential of maturing and releasing an egg. Second, a woman without PCOS would go through a normal hormonal cycle that would lead to the development of ONE dominant follicle. When you have multiple follies, the hormones (which are out of whack with PCOS anyway) have the potential of being distributed between the mult. follies and leading to immature development of all instead of complete development of one or a few.
Anywhoo, this is just my understanding and may be a bit off. I know it is very frusturating to sit out a cycle to take stupid BCP when you are TTC!! But in the end, you will probably have a better response and it will be worth it.
BTW, you mentioned injects and clomid? I have never heard of that, it is usually one or the other as they are both ovulation inducers, unless you mean an injectible Hcg to trigger ovulation. But if your doctor recommends injectibles, the course may likely be:
BCP, then start injectibles like Gonal-f, follistim, etc. starting around CD 3, then after follicle development (monitored by mult. blood work and us) trigger shot of HCG to induce ovulation of developed follies, usually around CD 14, then IUI 36 hours after HCG shot. Again, all RE's are different and follow different protocals, this has just been MY experience.

Hope this helps some!

Jenn

03-09-2005, 09:13 AM	#1 (permalink)
girlpooh 1000-4999 post queen of hearts Join Date: Mar 2005 Location: Washington DC Area Posts: 1,578	PCOS'r w/ IUI Questions Hello Ladies, DH & I have been TTC for about 2.5 yrs. I started with Clomid (50mg) and got PG in early Dec just and found out the day I had 1st appt w/an RE. Sadly enough I had a m/c in early Jan. So i have gone back to my RE and am back on the TTC road. I have recently been diagnosed with a "mild" case of PCOS. I have always had irregular cycles since I have had AF. After the M/C I hadn't had a cycle so they induced my AF to start all the "diagnostic" processes. Here's where I am so far: - Went in for day 3 monitoring and everything looks "normal" for my bloodwork except for my prolactin levels - they are really high. - I had 15 follicles on my right side, and 8 on my left --What can I expect the next steps to be? What sort of questions should I ask? My RE wants to do an IUI cycle, w/birth control and clomid. I'm thinking that maybe we should skip the B/C and do something more aggressive. But I don't know..does anyone have any thoughts as to why he would put me on B/C. That just seems backwards to me. They also want me to sign up for injectable classes, so i guess that good? What can I expect with having PCOS? I did some reading and don't have alot of symptoms that are usually associated with it. I actually only have two and that's irregular cycles and high prolactin levels. I want to know what to look for, when i go to the Dr's. I like to be an informed partner with my treatments rather than just a patient. Here's where I am so far: Follicles vs. Cysts - MY RE refers to them as follicles. He explains that Poly Cystic OS should really be Poly Follicle.... and not cysts. So I'm not sure about terminolgy. At any rate there were the 15 little "dots" on my right side and 8 on my left. - I did have a small dermoid type of cyst (specifically called it a cyst) on my left ovary that was very small and they don't think it will be a problem. Bloodwork - I have had B/W on CD3 and t/v ultrasound - I don't know what my Prolactin #'s are. I will call and see. Clomid - Prior to seeing the RE, I was on Clomid for about 8 cycles thru my OB. The 8th cycle is when i got PG. - My RE plans to do injectables w/clomid for my IUI Progesterone - When i was PG and he looked at my lining, he said it was very healthy and thick. Initially he prescribed the suppository, then he decided that I didn't need it. Ovulation - I do not ovulate on my own and noted that out through charting. SA - DH had that done and everything looked good. I had HSG done today and everything is wide open. Thanks for sharing..I look forward to this journey together.

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03-09-2005, 05:03 PM	#2 (permalink)
JenniferK Registered User Join Date: Aug 2004 Posts: 105	I will share what I know from my experience... I have severe PCOS, no male factor. After TTC with no medical intervention for 3 months ( I was diagnosed years prior, so didn't wait around) went to RE. Started on Clomid for one cycle, my RE said he doesn't believe in using Clomid for more than 3 cycles because it can actually start to have negative effects on fertility (thinning of lining, etc.) so I am surprised you were on it for 8 cycles. Well, it did drasticly thin my uterine lining and I had no follicle development, so I only used one cycle of Clomid. Then on to injectibles.... I have completed 3 cycles of injectibles (my RE wants to move on to IVF if this cycle doesn't work). I have used BCP between all of my cycles, it is very important for your follies to decrease in numbers and size after a non-successful cycle. In general, BCP's are beneficial to PCOS side-effects, but my understanding is the reason for BCP btwn cycles is 2-fold. 1st to decrease the potential for high-order multiple pregnancies that are risky to moms and babies. Every follicle has the potential of maturing and releasing an egg. Second, a woman without PCOS would go through a normal hormonal cycle that would lead to the development of ONE dominant follicle. When you have multiple follies, the hormones (which are out of whack with PCOS anyway) have the potential of being distributed between the mult. follies and leading to immature development of all instead of complete development of one or a few. Anywhoo, this is just my understanding and may be a bit off. I know it is very frusturating to sit out a cycle to take stupid BCP when you are TTC!! But in the end, you will probably have a better response and it will be worth it. BTW, you mentioned injects and clomid? I have never heard of that, it is usually one or the other as they are both ovulation inducers, unless you mean an injectible Hcg to trigger ovulation. But if your doctor recommends injectibles, the course may likely be: BCP, then start injectibles like Gonal-f, follistim, etc. starting around CD 3, then after follicle development (monitored by mult. blood work and us) trigger shot of HCG to induce ovulation of developed follies, usually around CD 14, then IUI 36 hours after HCG shot. Again, all RE's are different and follow different protocals, this has just been MY experience. Hope this helps some! Jenn