PCOS, trying to concieve with ovulation induction???

Question

im hoping to find out if anyone know's about this process?

I'm in my 20's, been trying for 3 years. So went to the gyno and he recommended ovulation induction for 4 months. I know my PCOS is bad (rarely get a period) but it seems so extreme. I hear of so many on clomid or metformin, but my gyno said OI is the ways to go, without really explaining. My Husbands count is slightly low, not enough to worry about. But i feel OI is scarey, all the needles, internal ultrasounds and blood tests - woah! and it cost $300 per month. i know that seems pety, but when so many successfully get pregnant on medication i would love to try that first. Am i entitled to talk to the gyno about his desision? so back and see him? get a second opinion? But on the other hand his one of the states leading fertility specialists, i guess he knows what he's doing. Has any one been through ovulation induction?

thank you all!

Answer 1

Well, different doctors have different protocols. If you are patient and can wait, then the routine is start with metformin only and try for a few months - at a minimum, this should help you regulate the cycle a bit better and maybe even ovulate. If your PCOS is bad enough, you should be on metformin regardless of what other ovulation meds that you are taking.

Then second thing to try is clomid.  The only reason to try this is it is much cheaper and not as cumbersome.  It is not as effective as injectables (OI), so can take a number of months.

The third try is injectables (OI) - this is a complete medicated cycle and makes sure that you ovulate.  Combined with IUI, it can be very effective.  If you don't want to waste time and want to make sure you have the best chance every month (and don't mind the extra dollar), then this is the way to go.

Since you are young, you could try all of the above (at a minimum, get metformin).  We skipped the second step (clomid) and went directly to injectables (and it worked).  Metformin only also worked for us later.

Added:  We did 3 months of metformin only, two cycles of injectables (one hyperstimulated cycle) with one IUI (got pregnant first time but miscarried).  later got pregnant again with metformin only in 2 months.

Good luck

Answer 2

You know what? The job of the fertility specialist is to get you pregnant as soon as possible - end of story. And they will use the most efficient way they know of to do it.  Does that mean that you should start off guns blazing with ovulation induction if you haven't tried clomid or femara first?  No. Don't ever think that by second guessing a doctor that you are being petty.  This is your body we're talking about and no one knows your body better than you do. The doctor is not god, the doctor's opinion matters, but if you are not comfortable with what the doctor is saying you should do, don't do it, get a second opinion or work out another form of treatment.

My fertility specialist wanted me to do 100 mg of clomid with 2000 mg metformin with hcg triggers and an iui - never mind that hubby's sperm count and quality was just fine. I thought that was rather extreme and didn't want to do it, especially since the Metformin was kicking my butt at only 500 mg. I felt that I should go the most conservative route for a few months and if it wasn't working, then we could talk iui, but only after I'd exhausted the conservative route. I didn't feel that I needed to go guns blazing right out of the gate. The fertility specialist said "okay" to my request, but I could tell she wasn't optimistic.

So I went to my regular obgyn who said 25 mg of clomid, 500 mg of metformin, and normal intercourse.  He was very optimistic that I'd do just fine and end up pregnant. And if 25 mg didn't work, we'd up it to 50 mg. No ultrasounds, no hcg triggers. We didn't need to even up the dose because I ovulated and got pregnant on the first try with clomid. I didn't need 4 times the amount of medicine or an iui to get pregnant. I never thought for one second that I did. I know my body better than any doctor ever could.

You may not need ovulation induction in order to get pregnant. The first line of treatment (in my opinion) provided that ovulation is your only problem shouldn't be ovulation induction with injectibles. You should try to go a conservative route first to see if it will work. Do not be afraid to take charge of your own reproductive health. I wish you success in whatever you choose to do.

Answer 3

I have PCOS too and I am in the process of  preparing to start Femara for the purpose on inducing ovulation.  It does seem a bit extreme that your Dr. would go from 0-60 without at least running some test.  Are you sure that he doesn't mean that you will have to take clomid or femara as your OI?  Neither of those require needles unless you need a trigger shot -  which is used if you growm follicles, but don't ovulate -  usually you have to be on the oral meds for at least 3 months.

Most women with PCOS don't ovulate on their own so you have to induce ovulation in some way.  You should ask your doctor why he is choosing t go for needles rather than oral meds -  if he is a top guy in the state -  he should be able to explain it to your satisfaction.  If you don't like his answer - get a second opinion -  it never hurts.

Answer 4

Have you tried metformin?  Some say PCOS patients will benefit from this; others differ.  Has the doc talked to you about your weight?   Is it an issue.  Some women reduce their BMI and voila, they ovulate!  If your Gynie wants to do clomid, it may be OK.  But if he wants to do injectables, this is more serious.  PCOS patients, far more than other women, are suseptible (sp?) to ovarian hyperstimulation.  It means what it says and is very dangerous.  If you want to go injectables, go to a RE.

Answer 5

Every dr is different but the first line treatment for ladies with pcos should be metformin and clomid, I suggest you talk to your dr about how you feel about the OI.

Baby dust

Answer 6

if you don't feel confident about going onto OI, then ask for more information, thats what specialist are there to do :) We are on our first month of OI with clomid(I have PCOS bad also, and im 22), I have had levels all over the place this month but have asked questions the whole way through which as given me a better understanding.

Trust your feelings, if its right for you then go for it. If not, then look for alternatives.