https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Sat, 23 May 2026 15:49:58 +0000 https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1776060 Wed, 23 Jul 2014 13:00:41 +0000 LaughLines 1776060@https://boards.hellobee.com/ <p>So i guess i have a different perspective... </p> <p>I was diagnosed with Lean PCOS based on ultrasound showing cysts and 100+ day cycles that only ended with progesterone induced periods. My OBGYN ran bloodwork at two different times and everything always came back normal, so the lack of periods and the cysts were what categorized me as PCOS. </p> <p>I started a low carb diet (not perfect... carbs are my weakness.. but i tried) and 1500mg of metformin every night. i got my period on my own for the first time 38 days after i started met, which was huge because the ONLY periods i got after going off of BC were progesterone induced. After that 38 day cycle, the next one was 40+ when i got impatient and asked for progesterone to start my period. Then for the cycle after the progesterone cycle i wanted to add clomid to the metformin so i took 50mg for 5 days and did OPKs to see if i ovulated. I got a positive opk, which was amazing because as far as i know i had never ovulated, and had good timing. My doc was going to have me come in for testing to "confirm" O, but i had to go out of town for work and missed the proper day for it. So i had no follicle monitoring and no O confirmation testing. </p> <p>My OBGYN said he doesn't usually do monitoring because it ends up being expensive and it shows how many follicles you have to give you a heads up if you aren't going to O or if you have a higher chance of multiples (multiple follicles), but it doesn't actually treat anything, just gives you info sooner than an OPK would and is more expensive. So i was fine with no monitoring. </p> <p>Turns out that one cycle of 50mg is all we needed! i got a BFP that cycle. The doc said if i would have gone 3 cycles (50, then 100, then 150) he would have referred me to an RE, but you're not really "wasting" clomid rounds by not monitoring because you're either ovulating or you're not, so clomid either works for you or it doesn't, so doing it under monitoring just confirms it earlier in the month vs an OPK or a BFP. If clomid isn't working for you, other treatment should be taken. So the monitoring can help you determine if you should go to other treatment sooner in a month, but does not really tell you anything different than just going through the cycle. </p> <p>anyway, that's just another take on it. I certainly understand not wanting to wait, esp since things are taking longer than you want them to. I think it really depends on your insurance and your willingness to pay for testing to get info sooner in the month. I also think that as the cycles go on, it may be harder to wait if a prior cycle was unsuccessful, so you'd want as much info as possible as soon as possible</p> <p>In short, i do not think your OBGYN is being irresponsible in saying they don't do monitoring, i think he or she is just taking a different approach with the level of info collected in each month and balancing it with the costs of that info. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1775231 Wed, 23 Jul 2014 02:07:45 +0000 Robyn_ZA 1775231@https://boards.hellobee.com/ <p>Hey @hoots.</p> <p>I'm lean pcos too, diagnosed at around 10yrs ago, so always knew we'd be in for a rough ride to start a family. I stopped the pill and had 4 periods over 12 months before they vanished totally. I went to see a specialist OB/GYN (I'm in South Africa so our steps and Dr titles differ a bit to the US), after all initial testing we finally got to give Clomid a bash. I'm ridiculously impatient so for me giving it a bash unmonitored for 3 months would have driven me crazy! It did nothing for me even on a extended course - small follies that never matured plus regressing uterine lining :( My androgens are just too intense. </p> <p>As some bees have said above, it can be tricky to pick your treatment plan. Go with whatever suits you and your DH and you hopefully have a great Dr/RE on board/supporting the plan.</p> <p>I've just had an intense lap op last week, and that combined with everything else we've gone through up till now, has led DH and I straight to IVF. Also have endo and a dash of male factor to deal with, so for us, we're happy knowing that we are going for the most hard core option that will best assist us :) </p> <p>It can be so hit and miss with trying to induce ovulation with PCOS that IMO anything unmonitored is potentially a horrible waste of hopeful emotions :goodluck: </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1775119 Tue, 22 Jul 2014 21:51:07 +0000 travelgirl1 1775119@https://boards.hellobee.com/ <p>@Hoots: It is so hard trying to decide which route to take when it comes to treatment. My DH was against it too but he was against IUI even more (he would do it now though) so he let me try it and now he actually refers people to my acupuncturist, lol. It's not for everyone though. Whichever route you take, lean PCOS is treatable and hopefully you'll have your baby soon! </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1775102 Tue, 22 Jul 2014 21:39:19 +0000 Hoots 1775102@https://boards.hellobee.com/ <p>@travelgirl1: I'd really like to explore that route, but DH is adamantly against herbs and acupuncture. I bought Vitex, but haven't taken any yet. I'm hoping I can convince him to at least give it a shot. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1775059 Tue, 22 Jul 2014 21:10:10 +0000 travelgirl1 1775059@https://boards.hellobee.com/ <p>@Hoots: I have lean PCOS too and could go a year without a period :sad: . My family doctor at the time was no use at all and said all my hormones were normal and it was probably wedding stress. So I started going to acupuncture and he referred me to a fertility clinic who gave me options of femera, IUI and then maybe IVF. Anyway, acupuncture and herbs kick started my periods and ovulation and the clinic agreed to do one month of cycle monitoring, and I got pregnant with my daughter. The same thing happened a few months ago, but sadly I lost that pregnancy. No drugs needed either time. I never imagined that would be possible a few years ago.</p> <p>So I guess my advice would be to start seeing an RE as soon as possible because they will look at everything, see the big picture and come up with a treatment plan for you. I also strongly recommend acupuncture, I swear it has worked wonders for me.</p> <p>Good luck! :goodluck: </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1775017 Tue, 22 Jul 2014 20:40:58 +0000 Hoots 1775017@https://boards.hellobee.com/ <p>Thanks everyone! You've pretty much confirmed what I was thinking. DH is in the medical field and going to (discretely) look into REs and the OBGYN I'm with. The OBGYN I see is with a pretty great practice in general, so I don't want to cut ties completely. The practice has some really well-known REs within it. So, I think we're going to keep trying until at least October and then ask for a referral to the REs there (if we can't get one sooner). I don't want to do unmonitored Clomid, so I think when we're ready to move to that I'll make another OBGYN appt. so that both DH and I can sit down with her. If DH and I don't feel comfortable with her level of expertise, which I'm assuming we won't, then we'll ask for the RE referral. It will also give us some time to become more familiar with the situation in general. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774833 Tue, 22 Jul 2014 18:32:25 +0000 swedishfish 1774833@https://boards.hellobee.com/ <p>@Hoots: I completely agree it's best not to waste Clomid cycles. I'd find an RE. I love my RE and wish I could stay there throughout my pregnancy. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774830 Tue, 22 Jul 2014 18:31:35 +0000 swedishfish 1774830@https://boards.hellobee.com/ <p>@bluestriped bee: I don't know if women with PCOS are at a higher risk for GD. I had one high number with the 3 hour test (two high numbers means you fail). The OB wanted me to take it again and I refused so they treated me as GD. My one high number was really high though so I was fine with being treated as GD. The diet made me lose weight and then helped me keep things under control during the last few weeks. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774827 Tue, 22 Jul 2014 18:29:22 +0000 ShootingStar 1774827@https://boards.hellobee.com/ <p>@Hoots: Just go straight to an RE. If you have PCOS your best bet is to have monitored cycles. Your OBGYN is just not well equipped to handle this. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774823 Tue, 22 Jul 2014 18:27:26 +0000 Hoots 1774823@https://boards.hellobee.com/ <p>@TheReelDeal: Yeah, I'm leaning towards the RE. I just got a bad feeling from the lack of explanation for the treatment plan and her surprise when I asked about monitoring and other random questions. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774809 Tue, 22 Jul 2014 18:16:20 +0000 Hoots 1774809@https://boards.hellobee.com/ <p>@bluestriped bee: We've been NTNP for about 3 months, but I haven't had AF naturally since 4/9/14. I went in in June and the OB/GYN took a history and did an exam and said PCOS was her best guess. She sent me for bloodwork, ultrasound, and gave me an RX for provera. I asked about femera, but she was pretty dismissive about it. She said she preferred clomid as it less expensive and been used for years. She seemed pretty adamant about trying the clomid before referring to the RE, which kind of put me off. She also said since the ultrasound showed cysts, my charts don't show O, and I've had no AF, she be willing to refer me sooner at the 6 month mark.</p> <p>@swedishfish: I'm calling insurance tomorrow. I guess I'm just not comfortable with the treatment plan from what I've read from others posts on HB. I feel like she may not be the best person to handle this, and I'd rather not waste cycles on clomid. I just don't know if it's worth finding another OBGYN or to go straight to the RE. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774801 Tue, 22 Jul 2014 18:11:28 +0000 BSB 1774801@https://boards.hellobee.com/ <p>@swedishfish: Ah, cool. Thanks, I'll need to remember that.<br /> Since infertility tests aren't covered, maybe I should go to my GP to get that blood test done. My insurance will probably cover that.</p> <p>Oh, did you have GD, too? Are we at a high risk of developing GD? </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774796 Tue, 22 Jul 2014 18:07:54 +0000 swedishfish 1774796@https://boards.hellobee.com/ <p>@bluestriped bee: blood work and ultrasounds while on Clomid. I would ask them to check your A1C level every year. The RE checked mine in May 2012 and April 2014. The endocrinologist I saw for GD checked mine in April 2013 and September 2013. Lots of needles, haha. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774793 Tue, 22 Jul 2014 18:06:28 +0000 TheReelDeal 1774793@https://boards.hellobee.com/ <p>I did not need a referral to see my RE. </p> <p>I was diagnosed with lean PCOS and I wouldn't wait if you think you'll go straight for the RE, they require a lot of testing in the beginning and that happens at specific times during your cycle and things can take longer than you expect. Clomid is hit or miss, some PCOS ladies here had success, there's no reason not to try it out, but also do your research about Femara. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774790 Tue, 22 Jul 2014 18:05:21 +0000 swedishfish 1774790@https://boards.hellobee.com/ <p>@bluestriped bee: me too...but I knew I had ovulation issues for years. My cycles have always been wonky. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774782 Tue, 22 Jul 2014 18:01:27 +0000 BSB 1774782@https://boards.hellobee.com/ <p>@swedishfish: What kind of monitoring do you have? Ultrasound and bloodwork? Since I was positive for insulin-resistant PCOS, I was bummed to hear that they don't usually check my insulin levels again. I would think they would for my case. Maybe I need to push them for that. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774780 Tue, 22 Jul 2014 18:00:37 +0000 KT326 1774780@https://boards.hellobee.com/ <p>Honestly, I would go to an RE. They are more knowledgeable about infertility than an OBGYN, even if the OBGYN has a "specialty" in infertility. </p> <p>It is only recommended to do 6 rounds of Clomid, I would want to know that I am getting the best possible chance especially if she is not going to be doing much monitoring.</p> <p>ETA: I had Kaiser with my first RE so my OBGYN had to refer me, but she was able to do it as soon as I told her we wanted to TTC given my history with lack of a cycle. When I switched insurance companies at work I did not need a referral to my new office. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774779 Tue, 22 Jul 2014 17:59:07 +0000 BSB 1774779@https://boards.hellobee.com/ <p>@swedishfish: Good point. I didn't need a referral for my insurance. (I have EPO insurance, so no referral's needed.) I got a referral to go to the RE before the 1 year TTC mark. ;) </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774772 Tue, 22 Jul 2014 17:56:23 +0000 swedishfish 1774772@https://boards.hellobee.com/ <p>Needing a referral depends on your insurance. I didn't need a referral so I was able to call and get an appointment with my RE right away. Definitely call your insurance and ask them.</p> <p>I was diagnosed as being "on the cusp" of PCOS with very little insulin resistance. I'm on Metformin, as per my RE. My OB wanted to put me on Clomid with no monitoring and I said no. My RE put me on 50 mg Clomid with monitoring and an IUI cycle. Clomid worked for me - I ovulated from two follicles but DH has male factor issues so we ended up doing IVF.</p> <p>Good luck! :goodluck: </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774769 Tue, 22 Jul 2014 17:53:23 +0000 BSB 1774769@https://boards.hellobee.com/ <p>I'm seeing an RE and they are the ones who diagnosed me with mild PCOS. I guess I fall into the lean PCOS and I'm, also, in the insulin-resistant PCOS category. </p> <p>I've been taking metformin for the last 3 months. I'm, also, on dexamethasone because I have DOR. </p> <p>Oh, leading up to my IUI cycle, I'm put on femera. I tried Clomid once and did not like it. Maybe ask about femera. </p> <p>How long have you been TTC? I saw an RE at 6 months of trying and here I am on cycle 26 of TTC. I did get a referral from my Ob/Gyn before going to an RE. </p> https://boards.hellobee.com/topic/lean-pcos-amp-when-to-see-an-re#post-1774757 Tue, 22 Jul 2014 17:42:15 +0000 Hoots 1774757@https://boards.hellobee.com/ <p>After three months with no AF, I got the official diagnosis of Lean PCOS today. We were going to hold off going full force on TTC until early next year. But after it became apparent it might not be as easy as we'd hoped, we threw the waiting out the door last weekend when I got my first positive OPK. (In retrospect, it was probably a false positive, but we weren't taking the chance. :wink: )</p> <p>I've done some reading on the subject in the past month, but I'm still pretty new to this. Anyway, OB/GYN did bloodwork and everything that came back so far is within normal levels. We are still waiting on androgen, vitamin D, and insulin resistance levels. Ultrasound results showed "numerous small cysts" on both ovaries. </p> <p>I wasn't extremely happy about the treatment options given. Basically, OB/GYN wants to do clomid (when I'm ready) &amp; metformin without much monitoring. 50 mgs to start and increasing to 100 and then 150 if no ovualtion. If that doesn't work, then she'd like to move me on to an RE. I was hesitant about the clomid option, so she suggested metformin alone for a few months. The other option is to go back on birth control for a few months and then come off again. While it sounds counterintuitive, she thinks because my cycles were so regular for 7 months after coming off bc that it might be worth a try. </p> <p>I'm really thinking about not messing around and seeing an RE. If that's the case, do most require referrals? Or should I wait and see what happens? Any other thoughts or encouragement on this or lean PCOS in general would also be appreciated. </p>