Ladies with PCOS - here is my plan. I hope this helps someone.

[Criosaidh]

Hi girls,

I was diagnosed at 16 with PCOS after seeing dieticians, immunologists, dermatologists... . My aunt actually finally diagnosed me correctly after searching my symptoms online. Google for the win.

I fell pregnant in August this year, and was ecstatically surprised, as I thought conceiving would be a nightmare. Sadly we lost our Doddle in an MMC at 12 weeks (baby actually stopped developing at 9 weeks ). I did a ton of research afterwards and found out the following things:

• Women with PCOS tend to have a higher risk of miscarriage than women without PCOS. Some studies have suggested that as many as 50% of women with PCOS experience a miscarriage compared to the average rate of 15% among the general population. (Source: Womenshealth website)

• 
  [*]In a study published in the Journal of Clinical Endocrinology and Metabolism, researchers reviewed the histories of 65 pregnant women with PCOS who were taking metformin prior to conception and throughout their pregnancy and 31 pregnant women with PCOS who did not take the drug. The women were patients at a fertility clinic in Caracas, Venezuela, and they were treated over a four and a half year period. Roughly 9% of the women who took the drug miscarried (six of 65), compared with 42% of women who did not (13 of 31). Among the women in each group who had a history of miscarriage, the rate of pregnancy loss was 11% for those receiving treatment and almost 60% for those not treated. The research was funded by the National Institute of Child Health and Human Development, a branch of the National Institutes of Health.
  Source: WebMD website

I have been to my doc and basically demanded Metformin. I was put on it previously but stopped taking it as I couldn't handle the stomach upsets it gave me. However, this time I'm determined to persevere. I'll be taking this possibly right the way through when I get my BFP, but at the very least until 16 weeks.

I've also cut out all refined sugars, caffiene, smoking (mostly, have had a bad week at work so have fallen off the wagon somewhat. Stopping again tomorrow ) and alcohol. This is going to be the healthiest Christmas I've ever had!

My advice is do your own research, and go with what your instinct tells you. Then badger the hell out of your doctors for what you want. This feels right to me, and I have researched it carefully and know what I need to be careful of.

I hope this is helpful to someone out there. My deepest sympathies for your losses, and FX'd for supersticky BFPs all round.

Crio X x X

 

[GreyGirl]

Thank you for that post and sorry for your loss
I have PCOS too, I've been pregnant once also, but had an ectopic (also higher incidence of these among women with PCOS compared to those without). I am hoping to also beat the odds this time round
I don't smoke or drink and eat fairly healthily (except my main failure - chocolate) and exercise moderately. I did have metformin but again couldn't handle the side-affects. IF I have a miscarriage the next time I have a BFP then I will consider having it again, but I would like to try without first.
I wish you all the best on your journey, please keep in touch with how it's going and if the metformin helps

 

[grandbleu]

Good luck Criosaidh and Greygirl - I hope you both get your BFPs very soon especially with your solid plan

 

[Criosaidh]

Thanks hun.

It was actually you who gave me the idea to post this - I hadn't thought about how many other ladies might have been here for the same reason.

C x x x

 

[Rowan75]

good luck ladies - when Im ready I may ask about metaformin and also Im hoping to try femara x

 

[hb1]

Hi

I was where you are If Met gives you tummy probs there are things you can do to help - take after meals - if still getting tummy probs ask about slow releasing Met - this is meant to be gentler on your system - I was ok on normal Met.

I found lots of info following my mc so thought would share it - the reason I felt met was right for me was looking at the info the insulin resistance - which is seen in a lot of cases of pcos - insulin resistance causes over-production of the insulin hormone which in turn causes hormonal inbalances which affect the hormones that both support the menstrual cycle as well as pregnancy prior to the placenta taking over. Having been on Met for years before ttc the first time my consultant put me back on and i stayed on till 17-18 weeks pg.

You are doing the right thing with your diet as keeping low GI avoids insulin spikes which in turn should help the potential hormonal inbalance.

Have posted my info below - although I can't remember the sources as it was nearly a year ago :

Insulin and insulin resistance. Some women with polycystic ovarian syndrome have insulin resistance, where an excessive amount of insulin is required to control blood sugar levels. High insulin levels stimulates further production of LH and testosterone. Excessive levels of insulin, LH and testosterone are associated with poorer egg quality, thus increasing the risk of miscarriage. Insulin resistance has been linked to recurrent pregnancy loss.

LH (luteinizing hormone) hypersecretion. Some women with PCOS have elevated LH during the follicular phase (first half of the cycle), which prematurely sends a signal to the egg that it is about to be released from its follicle. The egg then prematurely disconnects from its supporting cumulus cells, which causes the egg to pause in its maturation process.
It is thought that this interruption in the normal maturation process may result in abnormal chromosomes in the egg, which would then substantially increase the probability of a miscarriage. Other Hormones. Of course, other hormonal imbalances besides FSH and LH may be involved. Women who miscarry appear to have higher levels of testosterone and DHEA than women with continuing pregnancies. Women who miscarry may tend to have higher prolactin and androgen levels during the follicular phase of their menstrual cycle.


How does PCOS affect fertility and pregnancy?
PCOS can negatively affect fertility since it can prevent ovulation. Some women with PCOS have menstrual periods, but do not ovulate. A woman with PCOS may be able to take fertility drugs, such as Clomid, or injectable fertility medications to induce ovulation. To help ovulation occur, women also can take insulin-sensitizing medications or steroids (to lower androgen levels). Some research also shows that taking low doses of aspirin, which helps prevent blood clotting in the uterine lining and improves blood flow, can improve chances of pregnancy.
There appears to be a higher rate of miscarriage in women with PCOS (possibly by 45%). The reason for this is being studied.
Elevated levels of leuteinizing hormone, which aids in secretion of progesterone, may play a role. Elevated levels of insulin and glucose may cause problems with development of the embryo. Insulin resistance and late ovulation (after day 16 of the menstrual cycle) also may reduce egg quality, which can lead to miscarriage. The best way to prevent miscarriage in women with PCOS is to normalize hormone levels to improve ovulation, and normalize blood sugar, glucose, and androgen levels. Recently, more doctors are prescribing the drug metformin to help with this.

What Happens In The Body To Cause A Miscarriage In Women With PCOS?

There are some studies of miscarriage in women with PCOS which show it may be caused by high levels of insulin. This results in increased blood clotting in the uterus, which leads to placental insufficiency-failure of the placenta to get nutrients to the baby and remove toxic waste-and miscarriage results. Other studies have found a link between the higher levels of luteinizing hormone (LH), the hormone that stimulates ovulation, and miscarriage. High levels of androgens (male hormones) have also been indicated as possible contributors to miscarriage in women with PCOS. Researchers at the Virginia Commonwealth University medical Center discovered very low concentrations of two critical proteins in the uterine lining of pregnant women with PCOS. These proteins, which are secreted by the uterine lining during pregnancy, play an important role in the implantation of the embryo and sustaining the pregnancy.

Good luck ladies PCOS doesn't always win - sometimes we do I took my info to my gp after my mc and insisted on seeing a consultant.

hx

 

[GreyGirl]

Thank you for that very informative article - quite depressing though, reminds me of the odds I'm fighting against
Overall though it makes me hopeful to beat those odds!

 

[Criosaidh]

Thanks for the info hun, it's really useful.

Am now seriously considering baby aspirin on top of my other pills as I've read a lot of info that suggests clotting is a serious factor. They don't sell it in my local pharmacy though.

God, it's so much to take in! The diet is tricky too - low GI is expensive!

 

[GreyGirl]

It is really expensive! Plus time consuming, I often have to eat my main meal at work (even more expensive and hard to do low gi) because by the time I get home I don't have time to cook before I have to go bed
We'll get these! Do we have to get baby asprin prescribed? If it'll help reduce risk of miscarriage that's great...but could it affect the baby?

I think the most worrying thing about the article is about egg quality, I often ovulate between CD21-26...much later than day 16...does that mean my baby will most likely miscarry or have genetic problems in development??? Worried now!

 

[Criosaidh]

I thought about that too - my first ultrasound with little Doodle put my conception date at one week before my period would have been due. I don't know if they count from ovulation or implantation though.

I know I won't relax with my next pregnancy til I'm over the twelve week point though.

 

[hb1]

I think little steps are best - you can be more low gi just by choosing wholemeal options,and cutting out crisps and sweets - like any diet you can go to extremes or just make wiser choices - I have allbran and bran flakes for brekkie ( helps my ibs too ), have a whole wheat bread for my sandwich at lunch and have a sensible meal at teatime.

To be honest I did do baby aspirin but it was without any medical advice and I can't say whether it helped or not - I stopped after 24 weeks but it probably wasn't the wisest thing I did. I chose to as when I had my scan during my mc there were lots of blood clots in my uterus.

Also - remember these things area all based on averages and statistics - so no - it doesn't mean you will definately mc. Unfortunatley I hadn't been monitoring ov with my mc as I did when ttc after my mc so don't know if that was a contributing factor for me.

From the info I picked up I just felt that trying to balance everything out as much as poss was what I needed to do - that is what met was for, I increased my excercise ( actually lost weight !!! and with my pcos that is nigh on impossible!! ) and tried to eat sensibly. This way I would potentially combat any hormonal inbalance caused by my pcos.

The most worrying thing I thought was the 50% rate for mc for pcos women - the odds feel daunting - all you can do is give yourself the best chance - which is what your plan is doing.

From everything I read I also established that they still know so little about pcos - they can't agree what the issues are, what the treatments should be and what causes mc in pcos women.

Sorry if it was a bit of info overload


hx

 

[GreyGirl]

Thank you, another informative post
I eat fairly well, my main vice is chocolate, but I have cut it down a lot. Most other things I eat are wholemeal or fairly healthy - not perfect yet. My main thing has been increasing exercise - my cycles are getting shorter and I'm ovulating earlier than I did in March (that was day 26, I now ovulate around day 21-22) which hopefully means my trying to get healthier is working.
I think you're right that its about making small changes at first, every time I've tried to just go for it I've lost momentum and crashed.
It's great to know there are other pcosers around who are in the same boat

 

[Jasmine_rose]

Thanks for the info Im planning to try get my PCOS looked into again as I got diagnosed at 18 and Im 31 now. Its not particularly bothered me except for excess weight extra hair and yucky spots until this year when Ive tried to have a baby with my new hubby only to have 2 MCs.

 

[zoe0504]

Hi, I'm a little confused about PCOS myself, my doctors are useless, i was diagnosed through a laparoscopy about 2 1/2 yrs ago as i had trouble conceiving but also very irregular and painful periods. I have no other symptoms, not overly hairy or overweight but i had them drilled and conceived within 4 months. I have (thankfully) a happy healthy boy. I unexpectedly fell pregnant again this year but lost my baby at 14 weeks, HB stopped beating but i was told there was no reason for it. I woke up twice in a pool of my own blood and was again told there was no reason,bled constantly for about 7 weeks.
I was given no information from consultants or doctors and after the EVAC had no information to take out of the hospital. I read regularly on here and am constantly looking for advice but honestly don't know how bad my PCOS is.
I got a bfp today and am seriously scared about what the next few weeks/months have to bring. Can anybody share any advice or thoughts?
Sorry for the long rant, it's nice to get things off my chest once in a while!!
x x x x x xx