https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Thu, 09 Apr 2026 09:47:28 +0000 https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2130177 Thu, 02 Apr 2015 08:52:29 +0000 PurplePumps 2130177@https://boards.hellobee.com/ <p>I have no experience with PCOS, but as far as monitoring and Clomid goes... I don't think you're crazy for doing unmonitored cycles. It just works for some people and you may be one of those lucky ones. However, I did 2 cycles unmonitored with my OB, and in hindsight, I would not do anything unmonitored again. Looking back, that was 2 cycles of data that could have been collected and saved me that time. They would have seen earlier that it thinned my lining to just a hair of what my RE considered critical (6-7mm), they would have seen that my second round wasn't working (I didn't O until CD34). At this point, anything that the doctors want to *try* on me, I want to collect as much data from it as possible to tweak future cycles if needed. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2130025 Thu, 02 Apr 2015 06:16:34 +0000 Hoots 2130025@https://boards.hellobee.com/ <p>@DesertDreams88: My RE had me use the advanced digital opks (amazon has the best deal) and temp. I called the first day I had a solid smiley and she put in bloodwork orders for progesterone and estradiol. But if my temp didn't rise after 3 or 4 days I was supposed to call back and start opks again. The progesterone was how she could tell if I ovulated. I'm honestly not sure I would be comfortable with the progesterone without a confirmation that you have low progesterone or a short luteal phase. I might just ask for the bloodwork after O to confirm things. </p> <p>Also, I wanted to mention that maybe instead of clomid you could suggest trying femara. My RE's newsletter just had an article on femara vs. clomid for PCOS and apparently numerous studies have just come out showing femara has a better ovulation rate and live birth rate. The article said there's no increased risk of OHSS/multiple ovulation and it doesn't thin the lining. Apparently, there's no max on the number of cycles either. It's a bit more expensive, but it might be a good option for you since you're concerned about those things. It also wouldn't diminish your options with an RE.</p> <p>As for the metformin, my bloodwork showed very little signs of insulin resistance, but it's standard first-line treatment for PCOS. I wouldn't worry about it. The regular metformin comes in 500 mg or up pills. I couldn't get past 750mg/1000 mg. My ob/gyn thought that was fine, but my RE switched me to the ER formula, bumped me up to 1500 mg, and changed the diet to low glycemic with 60mg protein daily. I take 3 pills after dinner/ before I go to bed, which was opposite of what my ob/gyn told me. My RE said there was little use in the regular formula if it was making me sick, and the ER is really only slightly less effective. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129968 Thu, 02 Apr 2015 01:57:52 +0000 jaguar 2129968@https://boards.hellobee.com/ <p>@DesertDreams88: I would ask for bloods around CD14 (the "average" O time - though obviously that changes for everyone. And if no signs of O then, another one a few days later to detect a surge. Once you have confirmed O, you could ask for a 7dpo progesterone check. (Again, a day 21 progesterone check is just the average - no guarantees)</p> <p>Metformin seems to be a standard form of medication for PCOS. I've had bloods tested and am not insulin resistant, but I have wonky levels - so I'm on it more for maintenance and keeping things stable. Hopefully they have you on a relatively small dose to begin with? x </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129956 Thu, 02 Apr 2015 00:16:06 +0000 DesertDreams88 2129956@https://boards.hellobee.com/ <p>@hoots &amp; @jaguar: If I were to ask for bloodwork monitoring, what specifically do you think I should ask for? </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129955 Thu, 02 Apr 2015 00:15:15 +0000 DesertDreams88 2129955@https://boards.hellobee.com/ <p>@Hoots: yes, I think I'm O-ing on my own, so thank you for warning me that might correlate with OHSS! I'm definitely going to try to be vigilant about the signs. Another poster above was also concerned about the CD15 start date of progesterone, and I think both of what you said makes sense, so I will delay taking it until confirmed O. I am not as optimistic about a CD14 O-date as my obgyn is. </p> <p>In regards to metformin, your post encouraged me to look up some things about extended release potions, timing of doses, and diets. I will try to stick to the guidelines! So many to keep in mind! Do you think it is weird at all that he prescribed metformin without testing my insulin or glucose or what-have-you? Is that what your doctor did?</p> <p>I do not have confirmed low progesterone, but I think he assumed that between my loss, my PCOS, and some cycles with slow/low rising temps, it would be a good idea. </p> <p>I took mucinex last cycle and I think it helped, so I will continue! Thanks for the tip off about a possible estradiol prescription if need be. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129952 Wed, 01 Apr 2015 23:52:53 +0000 DesertDreams88 2129952@https://boards.hellobee.com/ <p>Madison43 &amp; Shootingstar: I'm planning on trying to be hyper aware of my body's responses to the meds, and I will def. call their office and push for monitoring if I think there's a concern. Then hopefully my doctor will tailor my treatment like yours did.</p> <p>Regarding the irresponsibility of doctors doing clomid without monitoring, I 100% agree. I'm going to do my best to stay in contact with their nurse (she's great) with any questions &amp; concerns, and to go to an RE starting in June or July after I can do research. </p> <p>I am pretty sure I ovulate on my own, but it might be "weak" ovulation. I've had 5 normal cycles off BC, and 4 long cycles.... each of the long cycles could easily be explained by something other than PCOS (severe work stress, miscarriage, flu, and too much B vitamins.) But the ultrasound seem pretty clear that it is PCOS :(</p> <p>@Shootingstar specifically: He plans to "monitor" me via temp tracking (I know that's not real monitoring, but w/e)... if I have a clear and defined temp shift, he wants to keep me at 50mg, and if I don't, he will consider bumping up the dosage and adding in ultrasound monitoring. </p> <p>Thanks for letting me know that temping is not as accurate with PCOS, I kind of look to that as the gold standard. I've temped for 6 total months now, and I follow the guidelines religiously almost - solid chunk of sleep, same time every day, no alcohol, etc. This month was affected by travel, but I did my best. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129950 Wed, 01 Apr 2015 23:44:53 +0000 DesertDreams88 2129950@https://boards.hellobee.com/ <p>Mrs. Jump Rope: Thanks for the heads up about the possibility of false OPKs! My doctor doesn't trust OPKs very much either, that's why he wants us to BD EOD and track temperatures (which, we've mostly been doing for 9 months...) </p> <p>Hmmm, interesting, good point about questioning the CD15 date for progesterone... he seemed to think that clmid will make me O on CD14 like clockwork, but I'm skeptical!! So maybe I will just wait it out until O is confirmed as much as possible via temps, cm, OPKs, etc... hopefully all the signs will line up! Then I'll take the P. I believe taking P before O will probably totally mess up O, because P counteracts estrogen. </p> <p>Yeah, I am keeping that 6 cycle lifetime limit in mind :( </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129949 Wed, 01 Apr 2015 23:36:20 +0000 DesertDreams88 2129949@https://boards.hellobee.com/ <p>@Laughlines and @MrsCobee: Thank you for sharing your experience! </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129903 Wed, 01 Apr 2015 21:21:11 +0000 mrscobee 2129903@https://boards.hellobee.com/ <p>I can attest to fertilaid and FertileCM helping me with my CM and getting pregnant, though not sure about in the context of pcos and don't know about taking with clomid... </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129896 Wed, 01 Apr 2015 21:12:20 +0000 jaguar 2129896@https://boards.hellobee.com/ <p>Clomid without monitoring AND with PCOS is very risky, to be honest. I think you would be better to do this with at least bloods, if nothing else. x </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129818 Wed, 01 Apr 2015 19:39:40 +0000 Hoots 2129818@https://boards.hellobee.com/ <p>1) No, I don't think you're crazy if you do unmonitored clomid. But if I remember right, you are ovulating on your own (just not as regularly as you should be). I believe there's a higher risk of OHSS with those ovulating on their own who use clomid, but I could be wrong. I wasn't ovulating, so my RE just monitored via bloodwork. I think I'd be pretty cautious about the clomid and progesterone combination with a hard start date for the progesterone of CD15. I think most people ovulate CD 14-21 on clomid, so you could start too soon. I'm sure others know more about this than I do, but that would concern me. I think the main thing is that you need to be comfortable with no monitoring and the plan in general. </p> <p>2) I think it's okay to ask to just do the metformin first. That's what I tried first as well. Unfortunately, it didn't work alone, but I don't particularly regret trying it. It's hard on your stomach though, so low glycemic diet is absolutely key. My OB/GYN didn't tell me that and I really didn't know how important it was until my RE came down on me for it. As for the progesterone supplement, do you have a history of low progesterone? If not, I'm not sure what that would do to help if the doc hasn't confirmed you have that issue. I definitely wouln't start the progesterone until you've confirmed you've ovulated. </p> <p>3) I don't have any experience with this.</p> <p>4) I took Mucinex and ate soy at the beginning of my cycle to try to help build my lining. I don't remember where I heard the soy thing, but it supposed to be estrogenic which should help build the lining. I've heard of others that have been given an rx estridol for the same reason, but I think that's after there's been confirmation of a thinned lining. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129810 Wed, 01 Apr 2015 19:26:47 +0000 ShootingStar 2129810@https://boards.hellobee.com/ <p>For me the monitoring was essentially with PCOS. Once I stopped BC I never got a natural period, so I wasn't ovulating at all. I would get surge's on OPKs and when they didn't get *quite* positive, I'd assume I'd had bad timing with the tests. </p> <p>Monitoring did change my treatment, to the extent that my meds dosing would get higher as the cycle went on without a lead follicle forming. And eventually we could see that I stopped responding to clomid altogether so I moved to Femara with injectables. </p> <p>I have to say that without monitoring, there's a really high possibility that you did not ovulate this month. You might have a second follicle, or that 13mm one might not have matured yet. Temping is only so accurate, ESPECIALLY with PCOS. </p> <p>But if you do ovulate and just need a little boost, then a couple of cycles of what your doctor recommended might be all you need. It all depends on how bad your PCOS is. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129804 Wed, 01 Apr 2015 19:24:08 +0000 Madison43 2129804@https://boards.hellobee.com/ <p>I don't know, I can understand why people do unmonitored cycles, but I personally wouldn't. I did not respond well to clomid so monitoring helped my doctor figure out exactly what was happening in there and tailor my treatment accordingly. I know the general rule is 6 Clomid cycles but I only did 3 because it impacted my lining negatively - I would have hated to waste those medicated cycles with my OB, and then have no real data when I switched to an RE. Plus there is a real risk of multiples - If I'm being honest, I kind of feel that it is irresponsible for doctors to give people clomid and send them on their way -- there's no way to know how your body will react. All that said, I don't ovulate at all on my own - I needed a lot of help. Maybe I'd feel differently if I just needed a little boast? </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129798 Wed, 01 Apr 2015 19:15:53 +0000 Mrs. Jump Rope 2129798@https://boards.hellobee.com/ <p>@DesertDreams88: I commented on your other post, too, and for me the monitoring was absolutely essential. PCOS can trigger false positives on OPKs, and there were times (for me) that i would get a negative OPK but have a surge defected at my REs office by blood work. Or, no surge detected at all so I'd need the trigger shot.</p> <p>I also took progesterone my last pregnancy &amp; was instructed to take it after ovulation. Clomid made me ovulate late - I was a pretty good CD17er for awhile, but the cycle I finally got pregnant I think I was a CD15. I started taking progesterone *after* ovulation occurred, though it's been a year now and I forget why it was important to start progesterone after. </p> <p>My RE had a very strict 6 lifetime cycles of clomid policy, and for that reason I would be wary of "wasting" any cycles unmonitored. I have two children and it too me five clomid cycles to have them. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129776 Wed, 01 Apr 2015 18:55:26 +0000 LaughLines 2129776@https://boards.hellobee.com/ <p>I commented on your other post too but I also didn't do monitoring. The monitoring doesn't actually change your treatment, it just sees how the treatment is doing. For me, opk's were enough monitoring because I never ovulated before and when I got a positive I knew the Clomid worked, so more tests weren't going to tell me more or change that. I got pregnant the first cycle of Clomid... If it had taken many months I probably would have asked for more monitoring/switched to an RE. </p> https://boards.hellobee.com/topic/pcos-now-diagnosed-treatment-questions#post-2129718 Wed, 01 Apr 2015 17:08:01 +0000 DesertDreams88 2129718@https://boards.hellobee.com/ <p>So, I just got back from my appt, and my doctor confirmed the diagnosis of PCOS. I have some questions I was hoping you all could help me with.</p> <p>History: 9 months TTC, 6 cycles, pregnant in Sept but loss in Oct. Long, irregular cycles ever since, but they've been improving. I was taking B complex Oct-Feb, which I think was having a negative effect, delaying O. </p> <p>Tests: I did bloodwork for LH, FSH, prolactin, and thyroid on CD36, right before AF showed. LH was high, everything else was fine. My CD12 ultrasound last week showed the classic "strand of pearls" look, but also a 13-mm follicle. I believe I ovulated CD 16 or 17; 4 days later (chart in profile). By then my follicle and lining should have been a standard size. We also had great timing. So, FX this cycle works out anyway!</p> <p>Treatments: My obgyn wants me to continue temping, and start metformin throughout the cycle, 50mg of clomid on CD5-10, and progesterone on CD15; with BD EOD. He said he only wants my temp charts; and didn't believe there was any need for monitoring via ultrasound or bloodwork. He said that often it's an "unnecessary waste of money and causes stress." That makes me nervous. I've read the warnings about it not being effective, being too effective (OHSS, multiples), and/or thinning out the lining. He said he will usually do up to 6 clomid cycles, but I am only willing to do 1 or 2 clomid cycles without monitoring.</p> <p>He also did not feel the need to do CD3 or 6DPO bloodwork, but he did agree to a SA at the start of my next cycle. </p> <p>Lastly, I do not want to switch from this OB for a least a couple of months, for a variety of reasons. He is an amazingly kind and supportive doctor; he's nearby, and his service is much less expensive than an RE. He also specializes in infertility. However, I will DEFINITELY consider switching in a couple of months, based on the feedback from my other post (<a href="http://boards.hellobee.com/topic/pcos-treatment-questions#post-2122138" rel="nofollow">http://boards.hellobee.com/topic/pcos-treatment-questions#post-2122138</a>) </p> <p>Couple of questions:<br /> - Am I crazy for even agreeing to 1-2 un-monitored clomid cycles?<br /> - Would I be crazy to ask if maybe I could try just the metformin &amp; progesterone next cycle? I'd start the P after temps confirmed O, which before the MC, my O date was consistently between CD15-19.<br /> - Anyone have any experience with an exophytic ovarian cyst (one projects out of the ovary?). It's only 1 cm wide, but... yeah.<br /> - Has anyone taken FertileCM for help with CM &amp; lining? Did you feel it was effective? Do you think it could interfere at all with the clomid or anthing else? </p>