PCOS- Shady Grove Push for IVF

[Anonymous]

Anonymous wrote:I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

What is your reason for wanting to try IUI first? It seems like a waste. If I told you that you had to undergo cancer treatment and could pick a treatment with a 10 percent success rate or 50 percent success rate, which would you advise me to choose? You’d be confused why I’d choose the 10 percent success rate treatment, right?

[Anonymous]

^DP but...cost, for one. But also invasiveness...it seems that (and was even recently discussed on this bord) tht IVF children tend to have more issues

[Anonymous]

Anonymous wrote:

Anonymous wrote:I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

What is your reason for wanting to try IUI first? It seems like a waste. If I told you that you had to undergo cancer treatment and could pick a treatment with a 10 percent success rate or 50 percent success rate, which would you advise me to choose? You’d be confused why I’d choose the 10 percent success rate treatment, right?

Op here. Cost and invasiveness. I wouldn’t go with higher odds just for sake of higher odds. Especially when I was able to conceive naturally once with PCOS. I too suspect an egg quality issue, and thought she would offer ways to boost that instead of immediately jumping to the most invasive procedure. Especially given my age and history. But, apparently it’s cimmon.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

What is your reason for wanting to try IUI first? It seems like a waste. If I told you that you had to undergo cancer treatment and could pick a treatment with a 10 percent success rate or 50 percent success rate, which would you advise me to choose? You’d be confused why I’d choose the 10 percent success rate treatment, right?

Op here. Cost and invasiveness. I wouldn’t go with higher odds just for sake of higher odds. Especially when I was able to conceive naturally once with PCOS. I too suspect an egg quality issue, and thought she would offer ways to boost that instead of immediately jumping to the most invasive procedure. Especially given my age and history. But, apparently it’s cimmon.

OP I'm not in the D.C. area anymore, but I have PCOS and had my first at 27 (with the help of letrozole). I'm now TTC #2 and the RE I'm seeing has said it's very unlikely we'll (need to) resort to IVF - she'll have me try 3 rounds of letrozole IUI and then (if needed) progress to cycles of follitism injections. These drugs (both letrozole and injectables), as I understand it, DO improve egg quality and strength of ovulation. I'm obviously not saying don't jump to IVF if that's what you want, but just so you know I received totally different feedback in what seems like a similar situation

[Anonymous]

Are you planning for this to be your last? I knew I wanted IVF because I had no living children yet and did not want to have to do multiple IUIs every time I wanted a child. IVF was predicted to give me multiple embryos which would make having a second or third much faster than if I just did IUIs each time.

[Anonymous]

Frankly with PCOS your best chance is IVF. I have PCOS & regular cycles for the majority of my life till I had and extra period when I was 29/30 and that's when my RE indicated that I had an anovulatary cycle. To much of my surprise found it odd but I had also gained a significant amount of weight and mind you we were not trying to get pregnant during this time. I had monthly OPK which responded well to 7 cycles of clomid with TI which did show I was ovulating, did 2 cycles of letrozole with one TI & the other IUI. we eventually decided to go ahead with IVF. During my clomid cycle I went on metformin for a year didn't lose any weight. ended up working out and eating right lost 40lbs close to my ideal weight, maintained weight for over 3 years to which we started trying to conceive without clomid/letrozle. still was not able to conceive even with regular cycles. initially we didn't have any male factor issues till the latter of when we decided to do our first IUI. that's when we decided to just go straight to IVF. We harvested 39 eggs 19 matured & 14 fertilized with ICSI. 5 made it to 5 day blast the remainder arrested at the morula staged. considering you are at high risk for OHSS I probabaly should have not transferred an embryo at the time. We still have 4 frozen and we are looking forward to FET in in the next few weeks. If you have IVF coverage go ahead and utilize it while u can. My previous employer paid up to 3 IVF cycles only could do one and then we had to move across state lines. DH does not have IVF coverage and mine has a limit of 10K. so for now we are doing FET out of pocket. Honestly ever since I got off clomid/letrozole & IVF I haven't been able to get my cycle close to normal since (was 28-30 days) now am well above 45-60 days which is very frustrating. When it comes to PCOS you have to really find what will work best for you as each case is unique in its own way. I wish you good luck in whichever way you decide to go. baby dust!!

[Anonymous]

OP here. Positive test this afternoon!! HSG cd 12 this month, and ovulated cd 15.

[Anonymous]

Anonymous wrote:There's a lot of speculation that there is an egg quality issue with PCOS. So even if you are ovulating regularly, you still may not have the best odds of conception (which if you've been trying for 2 years, seems likely.) IVF helps to separate the higher quality eggs from the lower quality because the lower may not fertilize or make it to day 5.

I ovulated regularly with PCOS and couldn't get pregnant. I decided IUI was a complete waste of time.

I agree with this. I got lots of embryos with PCOS in my 2 IVF cycles, but a lot were poor quality.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There's a lot of speculation that there is an egg quality issue with PCOS. So even if you are ovulating regularly, you still may not have the best odds of conception (which if you've been trying for 2 years, seems likely.) IVF helps to separate the higher quality eggs from the lower quality because the lower may not fertilize or make it to day 5.

I ovulated regularly with PCOS and couldn't get pregnant. I decided IUI was a complete waste of time.

I agree with this. I got lots of embryos with PCOS in my 2 IVF cycles, but a lot were poor quality.

NP. I've often wondered if egg quality was a factor in my infertility, in addition to the PCOS. Even when I managed to ovulate regularly, we never saw a BFP. Our only BFP was from a FET. My IVF cycle (at 36) resulted in 22 eggs retrieved, 12 embryos...and only 2 of them were PGS normal. Seemed low, based on my age at the time.

[Anonymous]

Anonymous wrote:OP here. Positive test this afternoon!! HSG cd 12 this month, and ovulated cd 15.

Congrats OP!

[Anonymous]

We did IUI with PCOS and it worked perfectly. The clomid helped me ovulate (which was my problem) and then the trigger shot helped time it even better (I'd had super long cycles before).

[Anonymous]

I have PCOS and got pregnant on my third IUI. I'm grateful I was able to skip IVF because of the additional meds and cost.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

What is your reason for wanting to try IUI first? It seems like a waste. If I told you that you had to undergo cancer treatment and could pick a treatment with a 10 percent success rate or 50 percent success rate, which would you advise me to choose? You’d be confused why I’d choose the 10 percent success rate treatment, right?

Op here. Cost and invasiveness. I wouldn’t go with higher odds just for sake of higher odds. Especially when I was able to conceive naturally once with PCOS. I too suspect an egg quality issue, and thought she would offer ways to boost that instead of immediately jumping to the most invasive procedure. Especially given my age and history. But, apparently it’s cimmon.

Agreed that IVF is costlier and more invasive. I have PCOS and conceived on my first try with IUI (at Shady Grove, where the RE suggested I start with IUI+letrazole). IVF is far more expensive-so unless you have megabucks or ultrahigh coverage insurance or very limited time, I don't know why you would jump to IVF (my insurance wouldn't have even covered IVF unless I had tried IUI first).

[Anonymous]

Op Here. Updating my thread in case someone finds themselves in the same situation in the future. I had a miscarriage at 8 weeks. Again, RE said let’s do IVF. I said I’ve now been pregnant twice naturally. I opted for a clomid cycle with TI. She really pushed for an IUI but we were closing on our house the same month and all out of pocket. Didn’t want to have to explain that $1800 charge to my lender days before closing. So, clomid and TI and I’m pregnant again four weeks after the miscarriage. This time I was on progesterone from ovulation until present. We heard a heartbeat at six weeks. With the miscarriage they delayed giving me progesterone and then had me stop it and start it again whereas with my daughter the RE immediately put me on it when I got my positive the cycle we were doing testing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

What is your reason for wanting to try IUI first? It seems like a waste. If I told you that you had to undergo cancer treatment and could pick a treatment with a 10 percent success rate or 50 percent success rate, which would you advise me to choose? You’d be confused why I’d choose the 10 percent success rate treatment, right?

Op here. Cost and invasiveness. I wouldn’t go with higher odds just for sake of higher odds. Especially when I was able to conceive naturally once with PCOS. I too suspect an egg quality issue, and thought she would offer ways to boost that instead of immediately jumping to the most invasive procedure. Especially given my age and history. But, apparently it’s cimmon.

Agreed that IVF is costlier and more invasive. I have PCOS and conceived on my first try with IUI (at Shady Grove, where the RE suggested I start with IUI+letrazole). IVF is far more expensive-so unless you have megabucks or ultrahigh coverage insurance or very limited time, I don't know why you would jump to IVF (my insurance wouldn't have even covered IVF unless I had tried IUI first).

Because so many women do NOT get pregnant with IUI and easily conceive with IVF. It can be an emotional toll getting BFNs with IUI. It’s not like IUI isn’t a pain. If you do IUI there’s a good chance you’ll still have to do IVF. So even more money when you consider the wasted IUIs.